Minimally Invasive Discectomy: Transforaminal Approach

2018 ◽  
pp. 43-51
Author(s):  
Abram H. Burgher ◽  
Kenneth M. Aló ◽  
Azmi N. Nasser
Keyword(s):  
Minimally Invasive ◽  
Transforaminal Approach

Percutaneous Endoscopic Interlaminar Discectomy for Intracanalicular Disc Herniations At L5–S1 Using a Rigid Working Channel Endoscope

2006 ◽  
Vol 58 (suppl_1) ◽  
pp. ONS-59-ONS-68 ◽  
Author(s):  
Gun Choi ◽  
Sang-Ho Lee ◽  
Pradyumna Pai Raiturker ◽  
Seungcheol Lee ◽  
Yu-Sik Chae
Keyword(s):  
Minimally Invasive ◽  
Invasive Procedure ◽  
Cerebrospinal Fluid Leakage ◽  
Favorable Result ◽  
Minimally Invasive Procedure ◽  
Transforaminal Approach ◽  
Interlaminar Approach ◽  
Endoscopic Discectomy ◽  
Disc Herniations

Abstract OBJECTIVE: Percutaneous endoscopic transforaminal discectomy is often used as a minimally invasive procedure for lumbar disc herniation. However, a transforaminal approach posts limitations at the L5–S1 level owing to anatomic constraints, such as a high iliac crest or small intervertebral foramen and especially for migrated large intracanalicular disc herniations. We discuss the procedure and clinical results of percutaneous endoscopic interlaminar discectomy using a rigid working channel endoscope at the L5–S1 level and the relevant surgical anatomy. METHODS: We performed percutaneous endoscopic discectomy through the interlaminar approach in 67 patients who satisfied our inclusion criteria during the period from March 2002 to November 2002. All procedures were performed under local anesthesia. Under fluoroscopic guidance, we performed discography using indigocarmine mixed with radio-opaque dye. The 6-mm working channel endoscope was then introduced into the epidural space. Herniated disc material was removed using forceps and laser under clear endoscopic visualization. We retrospectively evaluated the 65 cases with more than 1.5 years of follow-up. The patients were evaluated using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: VAS for leg pain (preoperative mean, 7.89; postoperative mean, 1.58) and ODI (preoperative mean, 57.43; postoperative mean, 11.52) showed statistically significant (P = 0.00) improvement in their values at the last follow-up examination compared with preoperative scores. Of the study group, 90.8% individuals showed favorable result. The mean hospital stay was 12 hours. The average time to return to work was 6.79 weeks. Complications included two cases of dural injury with cerebrospinal fluid leakage, nine cases of dysesthesia that were transient, and one case of recurrence. Two patients required conversion to open procedure at the initial operation. There was no evidence of infection in any patients. CONCLUSION: Percutaneous endoscopic interlaminar discectomy is a safe, effective, and minimally invasive procedure for the treatment of intracanalicular disc herniations at the L5–S1 level in properly selected cases, especially when the transforaminal approach is not possible because of anatomic constraints.

scholarly journals Endoscopic Transforaminal Discectomy for an Extruded Lumbar Disc Herniation

2013 ◽  
Vol 1;16 (1;1) ◽  
pp. E31-E35
Author(s):  
Albert E. Telfeian
Keyword(s):  
Minimally Invasive ◽  
Vertebral Body ◽  
Lumbar Disc ◽  
Scar Tissue ◽  
Herniated Disc ◽  
Transforaminal Approach ◽  
Endoscopic Discectomy ◽  
Back Surgery ◽  
Herniated Lumbar Disc ◽  
Herniated Discs

Microsurgery for lumbar herniated discs that require surgical intervention is a very successful and well-described technique, whether performed through more traditional “open” microsurgical retractors or through minimally-invasive “tube” retractors. Surgery for extruded lumbar disc fragments that migrate caudad or cephalad from the disc origin may typically require modifying the standard hemilaminotomy by removing additional laminar bone to retrieve the migrated fragment. Although midline and paramedian Wiltse approaches have been the standard methods for resecting herniated lumbar disc fragments, advances in neuroendoscopic techniques have expanded the potential targets for transforaminal endoscopic treatment to include extruded lumbar disc fragments. Sequestrations migrated cephalad or caudal to the disc can be removed using specialized flexible instruments. The instruments enable the surgeon to circumnavigate and reach into the epidural space and as far as the mid-vertebral body. The authors present a case of an endscopically resected lumbar herniated disc fragment extruded caudad behind the inferior vertebral body through a transforaminal approach in an awake patient using local anesthetic. Radiographic and endoscopic visualization make it possible to access intracanal pathology. Although more traditional lumbar disc surgery is widely performed and is safe and effective, neuroendoscopic procedures may also allow a safe and effective approach for even extruded disc fragments for patients who cannot tolerate general anesthesia or are seeking the most minimally invasive option. Endoscopic discectomy is a minimally invasive alternative to open back surgery. Maintained spinal stability and absence or minimal formation of scar tissue allow for ease of subsequent surgeries, both open and minimally invasive (if needed). Key words: Endoscopic discectomy, minimally-invasive, transforaminal, TESSYS

Considerations in Dysphagia Management Following Esophagectomy

2016 ◽  
Vol 1 (13) ◽  
pp. 169-176
Author(s):  
Lisa M. Evangelista ◽  
James L. Coyle
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Surgical Procedures ◽  
Esophageal Resection ◽  
Minimally Invasive Surgical ◽  
Operative Complications ◽  
Swallowing Difficulties ◽  
Epidemiological Impact ◽  
Invasive Techniques ◽  
Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

Minimally Invasive Approach for Wilms Tumor Treatment in a Small Child - A Case Report

Urology ◽  
2020 ◽  
Author(s):  
Alexandre Azevedo Ziomkowski ◽  
João Rafael Silva Simões Estrela ◽  
Nilo Jorge Carvalho Leão Barretto ◽  
Nilo César Leão Barretto
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Wilms Tumor ◽  
Small Child ◽  
Tumor Treatment ◽  
Minimally Invasive Approach ◽  
Invasive Approach

937: Minimally Invasive PCNL (MPCNL) According to the Chinese Method for Staghorn Stone: A Comparison with Traditional PCNL

2007 ◽  
Vol 177 (4S) ◽  
pp. 310-310
Author(s):  
Shu-Keung Li ◽  
Chun-wing Wong ◽  
Dominic Tai ◽  
Lysander Chau ◽  
Berry Fung ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Staghorn Stone ◽  
Minimally Invasive Pcnl

1704: Treatment of Staghorn Calculi by Chinese Minimally Invasive Percutaneous Nephrolithotomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 548-548
Author(s):  
Xun Li ◽  
Guohua Zeng ◽  
Jian Yuan ◽  
Chichang Shan ◽  
Kaijun Wu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Staghorn Calculi ◽  
Minimally Invasive Percutaneous Nephrolithotomy

V1695: Minimizing Minimally Invasive Surgery: the Three Port Robotic Pyeloplasty

2004 ◽  
Vol 171 (4S) ◽  
pp. 448-448
Author(s):  
Farjaad M. Siddiq ◽  
Patrick Villicana ◽  
Raymond J. Leveillee
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Robotic Pyeloplasty
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