What is the difference with other optical systems (microscopes or loupes)?

MICROSCOPIC OR OPEN:

Many "endoscopic" and microsurgical techniques are possible. Strictly speaking, they are miniaturisations of open surgery, but technically the procedure is performed in a traditional way. A collateral damage in the back is created just to access the hernia; an artificial space and opening are created to technically carry out the operation.

This access is relatively rigid to work in, tissues hinder mobility. To compensate, one goes:

Stretch or loosen the tissue extremely open (back muscles).

Remove the yellow ligament that sits above the spinal cord and nerve tracts.

Remove bone purely to see the hernia or to be able to move with surgical instruments.

FULL-ENDOSCOPIC:

The difference is where the lens used to look is located. Since the lens of an endoscope is located in the operation area at a few mm from the anatomy, the image is extremely detailed and magnified

When using magnifying glasses or a microscope, the view from outside the operation wound is less superficial.

The endoscope looks at an angle of 25 degrees and is located in the anatomy, which makes it possible to really look "around the corner" at places that remain invisible with direct vision. It is a kind of periscope.

The endoscope continuously irrigates the operating field with water, which is a very big advantage compared to open techniques. The operating field is free of tissue debris and blood, resulting in more detail of the anatomy to be operated on (colour, shape and texture). An additional advantage of this continuous rinsing is the flushing away of possible bacteria.

 INTERLAMINAR ACCESS:

The yellow ligament is pushed open like a curtain. In classic surgery this is removed

Bone resection is often not necessary for surgical access. With the open technique, a laminectomy is performed in order to be able to see better and to move the surgical instruments around.

The endoscope is very mobile due to its small diameter and can look "behind the corner" like a periscope.

Spine endoscopy through the two natural windows of the back, transforaminal and interaminal

THE TRANSFORAMINAL ACCESS IS NOT EVEN MICROSURGERY POSSIBLE!

In foraminal hernias, the disc clot is located in the neuroforamina. This is the same small opening through which the exiting nerve must pass.  For an endoscopic lateral access (side), this is easy to remove. It is precisely through this route that all these procedures are performed. Classical open access routes make it very difficult to approach the neuroforamina. A large incision and extensive bone resection are usually required. Sometimes the wall of the foramen has to be opened up by extensive bone resection and the link has to be fixed as a result.

THE CHOICE OF ENDOSCOPIC ACCESS IS DETERMINED BY THE SURGEON WITH THE AIM OF TREATING IN THE LEAST TRAUMATIC WAY POSSIBLE AND WITH THE GREATEST CHANCE OF A SUCCESSFUL OUTCOME.

HIGHLY MINIMALLY INVASIVE

NO DAMAGE TO HEALTHY TISSUE

AVOIDING FUSION of the back or neck

AVOIDING DISC PROTHESIS