Minimally invasive extended strip craniectomy. This procedure use very small incisions – only about 1.5 inches – placed at the ends of the sagittal suture. Through these small incisions a wide strip of bone including the sagittal suture is removed. Additional wedges of bone are removed behind the coronal suture and in front of the lambdoid suture. These additional cuts allow the skull to widen against minimal resistance. After the procedure a helmet is typically worn to harness the growth of the brain to widen the skull. Ideally the skull is mildly over corrected (made slightly wider than normal) because the remaining growth in the skull will still tend to grow from front to back. Slight overcorrection results in a normal head shape when the skull is fully grown.
The head shape changes after the minimally invasive extended sagittal strip craniectomy occur rapidly. After closing the incisions on the operating table a change in head shape is visible.