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Full Endoscopic Lumbar Hernia Surgery

Lumbar hernia surgery (lumbar discectomy) is a surgical method to remove the hernia that is pressing on the nerve or spinal cord. When this procedure is performed with an endoscope, full endoscopic herniated disc surgery  is called. It is considered a minimally invasive procedure. Because it is enough to make only a small incision on the patient's body. The endoscope (a small metal tube with a camera and light at the end) provides direct viewing through magnified video images; In addition, surgical instruments pass through this tube, so that the patient's muscles do not need to be stripped and damaged. As a result of minimal damage to bone and muscle tissue, patients with closed hernia surgery experience less surgical trauma and recover faster.

Intervertebral discs are cartilage that lie between the bones of the spine and cushions that act as shock absorbers. As a result of aging, wear and tear, or injury, discs in the lumbar spine can herniate and put pressure on adjacent nerves, causing pain, numbness, or loss of strength in the lower back, legs, or hips. Before your neurosurgeon determines the exact cause of back or leg pain and plans treatment  Performs a physical examination to check reflexes, muscle strength and movements. If nerve compression is suspected, CT scan, MRI scan may be ordered with additional diagnostic tests. Electromyelography, that is, nerve conduction studies, can be additionally performed as an auxiliary test to find the source of nerve damage.

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When is Full Endoscopic Hernia Surgery Recommended?

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Completely closed herniated disc surgery typically results in pain, weakness, paralysis, or numbness that does not respond to conservative treatment methods such as exercise, stretching, corticosteroids, pain medications, or physical therapy.  herniated disc  recommended for patients. This surgical technique may be an option for people with sciatica (pain going down the leg) to minimize pain. Fully closed herniated disc surgery, usually with progressively worsening numbness or loss of strength in the legs; so it can be used to treat patients with severe limitation of movement.

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Advantages of Full Endoscopic Lumbar Hernia Surgery

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Fully closed lumbar hernia has many advantages over traditional microsurgical lumbar hernia surgery. The benefits of this minimally invasive procedure include:

  • This surgery can be performed with local and sedation without giving general anesthesia to the patient.

  • Short recovery time (patient can be discharged on the same day.)

  • Small incision and leaving a small scar from an aesthetic point of view

  • Minimal blood loss

  • No loss of spinal mobility thanks to the preservation of tissues

A fully closed endoscopic herniated disc carries less risk than traditional spine surgery, and as a result, patients recover more quickly and return to their daily activities faster.

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How to Perform Full Endoscopic Lumbar Hernia Surgery

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Patients are administered with general or local anesthesia before the procedure. A small incision (1 cm.) is made near the waist for the endoscope and other instruments to pass through. A video monitor displays live, magnified images from the camera end of the endoscope transmitted from the camera. After the instruments enter the hernia site, the surgeon removes the herniated disc and the damaged part that is pressing on the nerves and causing symptoms. When the procedure is completed, the endoscope is removed and the incision is closed by suturing. The average duration of a fully closed herniated disc surgery is 30 minutes. is.

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Risks of Full Endoscopic Lumbar Hernia Surgery

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Fully closed herniated disc surgery is considered a safe and minimally invasive procedure. However, as with any surgery, the following risks exist:

  • excessive bleeding

  • Side effect due to anesthetic agents

  • Infection

  • nerve damage

  • spinal fluid leak

There is also a 5% risk of recurrence of herniated disc after surgery.  

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Recovery After Full Endoscopic Lumbar Hernia Surgery

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Patients can usually return home on the day of surgery. Initial pain from surgery can be treated with pain medication. Patients are advised to avoid bending, lifting or twisting for several weeks after the procedure. Nerves may take some time to heal, and patients may experience temporary numbness and tingling in the legs. Most patients can return to work approximately 2 to 4 weeks after the procedure, but those with physically demanding jobs may have to wait longer to return to work. After the recovery phase, most patients experience a significant reduction in back and leg pain after undergoing a hernia surgery.

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Dr. Tamer Tekin

Fully Closed Lumbar Hernia Surgery
Fully Closed Lumbar Hernia Surgery
Tam Kapalı Bel Fıtığı Ameliyatı - Endoskopik | DRTAMERTEKİN
01:01

Tam Kapalı Bel Fıtığı Ameliyatı - Endoskopik | DRTAMERTEKİN

Dr. Tamer Tekin Tam Kapalı Bel Fıtığı ameliyatı (Transforaminal Endoskopik Diskektomi). Endoskopik cihazlar kullanılarak yapılan bel fıtığı ameliyatına endoskopik bel fıtığı ameliyatı adı verilmektedir. Minimal invaziv bel cerrahisidir. Kimi cerrahlar tarafından tam kapalı endoskopik bel fıtığı ameliyatı olarak da adlandırılsa da bence yanlış bir tariftir. İngilizcede ''Full Endoscopic Spine Surgery'' olarak geçmektedir. ​ Cerrahi işlemi gerçekleştirmek, özel ekipmanlar ve cerrahi deneyim gerektirir. Kullanılan el aletleri, mikrocerrahide kullanılan aletlerden daha küçük ve daha uzundur. Mikrocerrahi teknikten farkı kaslar ve kemik dokulara zarar verilmeden bel fıtığı kolayca alınabilir. Genel ya da lokal anestezi ile rahatlıkla uygulanabilir. 0,5 - 1 cm. lik küçük bir kesi yeterlidir. Belin ortasından ya da belin yan tarafından omurgaya ulaşma imkanımız vardır. Ameliyat sonrasında hasta günlük hayatına çok kısa zamanda dönebilir. Endoskopik bel fıtığı ameliyatının, mikrocerrahi bel fıtığı ameliyatına göre farkı: ​ Küçük aletlerle çalışılması ​ Küçük kesi yapılması ​ Operasyon bölgesindeki dokularda çok az hasar bırakması ​ Hastanın eski hayatına çabuk dönebilmesi ​ Hastanın aynı gün taburcu edilebilmesi ​ Enfeksiyon riskini azaltır ​ Kemiklere zarar verilmemesi implant kullanılma zorunluluğunu ortadan kaldırır. ​ Aynı delikten çok sayıda fıtığa müdahale edilebilir. İletişim: +90 541 5395979 E-mail: info@drtamertekin.com https://www.drtamertekin.com
Transforaminal Endoscopic Lumbar Discectomy | DRTAMERTEKIN
09:42

Transforaminal Endoscopic Lumbar Discectomy | DRTAMERTEKIN

Transforaminal Endoscopic Lumbar Discectomy performed by Dr.T.Tekin Low back and sciatic pain have been one of the most common and disabling spinal disorders recorded in medical history. Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Mixter and Bar first published results of laminectomy and discectomy for lumbar disc prolapse. Yasargil and Caspar started the use of microscopes for posterior discectomy which limited the skin incision and lead to less muscle and epidural scarring. Patients had less postoperative pain, early rehabilitation, and early return to work. Due to these advantages, microdiscectomy became the gold standard in disc surgery. Hijikata (1975) independently experimented with mechanical nucleotomy via a 2.6-mm-od cannula that was inserted into the center of the intervertebral disc via a posterolateral access. He reported a satisfactory postoperative outcome in 64% of patients. Kambin and Schaffer (1988) used arthroscope for visualization and excision of the disc. Yeung developed rigid working channel endoscope for percutaneous endoscopic lumbar discectomy (PELD). The advantage of a percutaneous endoscopic discectomy is that the disc is approached posterolaterally through the triangle of Kambin without the need for bone or facet resection thus preserving spinal stability. There is less damage to muscular and ligamentous structures allowing for faster rehabilitation, shorter hospital stay, and earlier return to function. Although many studies have shown the efficacy of PELD with good clinical outcome, the percutaneous approach poses challenges to surgeons and the PELD, the learning curve is usually perceived to be steep. Major complications such as nerve root injury, dural tear, haematoma, visceral injury, vascular injury, and infection may occur, possibly resulting from lack of skilled surgical techniques during the learning period. The purpose of this study was to report the results of PELD by a single surgeon who had not been previously exposed to this procedure. www.drtamertekin.com
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