How I do it: tuck-in-pocket technique for microvascular decompression

Interposition during microvascular decompression (MVD) is effective but may be associated with recurrence and may be insufficient for large or ectatic vessels. The tuck-in-pocket (TIP) technique uses a Teflon sling secured within a small dural pocket in the petrous dura or tentorium to transpose the offending vessel after standard retrosigmoid exposure. The TIP technique provides a simple, fixation-free method for vascular transposition and may serve as a feasible and safe alternative MVD method in neurovascular compression syndromes.