Instrument-Handling Guide
Introduction
Biportal Endoscopic Spine Surgery, so
called BESS, is an ubiquitous
technique to solve the spine problem
in these days. It needs just a few
instruments designed for the
circumstances under water with
viewing down the deeper and inner
side of the spinal canal. Endocare
s y s t e m a n d i n s t r u m e n t s a re n o w
introduced.
foraminal stenosis(FS) has same way at first a
few steps such as Adequate positioning of
inlets, Fluent saline flow, Making working
space, Partial Laminectomy and
D i s c e c t o m y, To t a l F l a v e c t o m y, a n d
Checking the condition of the roots. Every
step needs optimal handling of a certain type
of instruments.
Let’s meet and shake hands with the
instruments! We can hear the stories of their
journey.
BESS for lumbar disc herniation(LDH), lumbar
spinal stenosis(LSS) in lateral recess, and
A.
C.
B.
D.
A. “Muscle detacher” snatched out the base of the
interlamina space to make a room for saline infused.
C. “Bishop & K-punch” detached ligamentum
flavum(LF) from the bony margin of the distal lamina.
B. “Bishop” curetted the surface of the lamina to
make a clean space to help your orientation.
D. “Bishop & Maximus” removed LF totally and
probed the disc condition under the root.