Endoscopic spine surgery (ESS)

Endoscopic spine surgery for chronic pain syndromes and discopathies is playing an increasingly important role in modern minimally invasive spine surgery.
Endoscopic spine surgery (ESS) is a modern surgical technique in which, through a micro-incision, the surgeon inserts an endoscope into the spine in conjunction with a camera to visualize the surgical field.
Although endoscopic surgical methods have been widely used for years to treat the gastrointestinal tract, for example), only recent advances in optics, tissue visualization and spinal imaging have made endoscopic spine surgery the optimal and safest choice for spinal surgery for many patients.
Spinal procedures performed with endoscopic technique, thanks to the use of an extremely thin endoscope with a high-resolution endoscopic camera and visualization of the surgical site on a 4K monitor, allow minimally invasive and much safer access to the operated tissues for the patient compared to the classic open and minimally invasive surgeries traditionally used.
Modern endoscopic technique in spine surgery is mainly used in discopathy and degenerative disease of the spine / spinal disc and treatment of herniated spinal disc.

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At our Center for Endoscopic and Minimally Invasive Spinal Surgery at KCM Clinic Hospital, neurosurgeons and neuroorthopedists, experienced in this technique, perform surgical procedures using the latest generation of equipment from the world leader in endoscopic spine technology, i.e. Rivo Spine (formerly Richard Wolf GmbH), in a state-of-the-art multimedia operating theater.

Minimally invasive spine surgeries performed with endoscopic technology, together with modern and highly sensitive endoscopic imaging using an endoscope, camera and monitor, as well as special microsurgical techniques, are able to further reduce the pain and access incision experienced by patients.

All of the surgeon’s manipulations with the endoscopic instruments, thanks to the high quality 4K images, are directly controlled on the monitor and guarantee a high level of procedure efficiency and safety. The procedure generally takes up to one hour, hospital stay up to 2 days.

Thanks to the development of innovative endoscopic instruments and techniques, and the very good effectiveness of these procedures confirmed in multicenter scientific studies around the world, minimally invasive endoscopic spine surgery today has much broader indications. Today, endoscopic spine surgery is used in procedures not only on the lumbar spine (lumbosacral section) but also on the thoracic and cervical spine for specific indications.

It should be emphasized that a very big role in spinal diseases and treatment of disc herniation of the cervical, thoracic and lumbar spine is played by professional rehabilitation and physiotherapy before and after surgery, in addition to an experienced surgical specialist and precisely performed surgery.
A comprehensive approach to the patient with specialized on-site diagnostics at KCM Clinic hospital (MRI, CT scanner at Omega Diagnostics Imaging, rejestracja@omegadiag.pl), with pre- and post-operative outpatient care at the Spine Surgery and Pain Management Clinic, Neurosurgery Clinic, Neurology Clinic, Orthopedic Clinic and other specialty clinics, along with professional on-site rehabilitation under the care of experienced physiotherapists, is a guarantee of success and long-term stable improvement.

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    1. Endoscopic spine surgery (ESS, endoscopic spine surgery)

    is now a highly advanced and undoubtedly state-of-the-art form of minimally invasive spine surgery. This technique allows the patient to have a much faster recovery time and faster pain relief than traditional open spine surgery methods.
    Endoscopic spine surgery also helps to preserve the spine’s normal range of motion after surgery, which is especially important, especially in younger patients who want to quickly return to health and sports activities. Often, the procedure can be performed using regional anesthesia instead of general anesthesia, which significantly reduces overall medical risks in older patients or those burdened with other diseases.

    2. What is the main difference between endoscopic spine surgery and other types of spine surgery?

    Endoscopic spine surgery, in the experienced hands of a spine surgery specialist, offers patients many potential benefits, including:
    – the endoscopic procedure is performed by microdissection, a technique that reduces the need to incise skin tissue and the spinal muscles (less perioperative trauma)
    – less blood loss
    – much less postoperative discomfort and pain
    – short hospital stay (1 day)
    – rapid convalescence and short healing time

    3. What are the indications for endoscopic spine surgery?

    Endoscopic spine surgery is mainly indicated in chronic refractory spinal pain syndromes when diagnosed with degenerative spine disease, so-called “discopathy” and treatment of disc herniation. However, this technique may not be suitable for other indications for spinal surgery, such as scoliosis, spinal trauma or instability, and cancer. In such cases, based on the results of specialized tests like an MRI or CT scan of the spine, the surgeon may recommend a different type of surgery – traditional open or minimally invasive but not endoscopic.

    4. Is endoscopic spine surgery safe?

    Advances in medical technology and optical technology have allowed the development and development of an extremely modern and even revolutionary technique of endoscopic spine surgery.
    In the hands of a highly skilled and experienced surgical specialist, the potential benefits of this extremely minimally invasive endoscopic surgical technique can provide pain relief and highly effective treatment for today’s generation of patients suffering from chronic spinal pain syndromes.

    5. Benefits of endoscopic spine surgery vs. its risks

    As always and with any type of spine surgery, also with endoscopic techniques, there are benefits and risks associated with the operation. Therefore, it is extremely important to weigh with your surgeon all of your personal potential benefits and individual risks associated with treating your spine disease with an endoscopic spine surgery procedure during your consultation after a thorough diagnosis and discussion of your findings.
    Among the most important benefits is the small incision of the surgical site, which causes less trauma to the skin, muscles and soft tissues and results in less blood loss and a shorter recovery time with faster recovery. Most endoscopic procedures can be performed in about one hour, allowing the patient to be up and running more quickly , who can often be on their feet just a few hours after the procedure.
    Potential risks: Endoscopic spine surgery is a highly specialized surgical skill, and relatively few spine surgeons have the experience and sufficiently large number of procedures performed and perform these procedures regularly to be proficient.
    Endoscopic spine surgery is generally not suitable for revision surgery, in patients with pronounced spinal instability, high-grade spondylolisthesis or in cancer.
    Spine surgery specialists at KCM Clinic are among the most experienced in Poland and Europe, and KCM Clinic organizes international scientific and training conferences with LIVE transmission from the operating room in the field of endoscopic and minimally invasive spine surgery.

    Spinal surgery – questions

    Are you a candidate for spinal surgery using the endoscopic technique?

    Common spinal conditions that may be an indication for endoscopic spine surgery include so-called disc disease, moderate or severe intervertebral disc herniation, facet arthropathy, recurrent sciatica as well as spinal canal stenosis.
    Spinal disease must be diagnosed not only on the basis of the patient’s history and clinical examination, but also confirmed by diagnostic imaging (MRI, CT scan).
    However, it should be emphasized that spine surgery should not always be the first course of treatment. As a rule, it is recommended that other types of non-surgical treatment (drug therapy and rehabilitation), be tried before any type of surgical treatment of the spine, including endoscopic spine surgery.

    How is endoscopic spine surgery performed?

    The endoscopic procedure is generally performed under local anesthesia or analgosedation. After being placed on the operating table, the patient is prepared for the procedure, with a local anesthetic administered to block pain. Through a skin incision under scopic control, a so-called working trocar, or rigid tube, is inserted into the operated area. Access to the spine, depending on the patient’s specific diagnosis and the doctor’s choice of technique, can be through the so-called intralaminar access (from the back of the spine between two plates) or transforaminal access (transforaminal from the back/lateral side of the spine).
    A thin endoscope ending in a tiny camera is then inserted through the trocar into the targeted area of the spine undergoing surgery. Through the endoscope, microsurgical instruments are inserted with which the surgeon operates. Throughout the endoscopic operation, the camera captures and displays real-time, very high quality images of the operated area on a monitor, watched by the surgeon. The endoscopic camera with visualization of the surgical field assists the surgeon during the operation, and when the operation is complete, all instruments, the camera and the endoscope with the trocar are gently removed. The skin incision is sutured and a small dressing is applied.

    How does endoscopic spine surgery work?

    Endoscopic minimally invasive spine surgery is performed using a general or local anaesthetic. In both cases, you will not feel any pain as the treated area will be completely numb.

    The first step of the procedure consists of making a 15-millimetre incision and introducing an endoscope. A dilator will be used to keep the incision open. This will allow the surgeon to see live images of the inside of the spinal canal. The main objective of the procedure is to try to remove the herniated vertebral disc tissue with the help of forceps. This is performed from the inside of the herniated disc, so the risk of damaging the spinal cord is drastically reduced. This will help relieve any compressed nerves. In addition, with this technique, it is possible to introduce medication more directly, as it’s easier to reach the areas where pain is located. At the end of the procedure, all instruments are removed and the incision closed.

    The duration of an endoscopic minimally invasive spine surgery is typically between 30 minutes and 1 hour.

    How do you prepare for endoscopic spine surgery?

    If you think endoscopic spine surgery might help or if your doctor has suggested this procedure, get in touch with us. One of our patient coordinators will get back to you to ask you questions about your current health and explain how the procedure works in detail. In order to assess your eligibility for endoscopic spine surgery, you will need to send us an MRI or CT scan of your spine, performed within the last 6 months. Make sure you pack your test results with you when you visit our clinic, including the CD. The test description alone is not sufficient.

    You will be informed whether you need to perform other medical tests; this will be assessed by our neurosurgeon, Dr. Stanisław Kwiek, who will also perform the procedure. Once you’re admitted to KCM Clinic, you will also have an anesthesiological consultation. You will most likely stay at our clinic for two days. Please also consider that you won’t be able to drive a car for some time after surgery. We offer pick-ups and drop-offs to and from the airport to all our international patients to make your experience on site as worry-free as possible!

    Post-surgery: How’s recovery like after endoscopic spine surgery?

    Usually, the patient is admitted in the morning, and during the same morning the operation is performed. The next day, the patient can go home wearing a lumbar corset.

    Overall, recovery is faster than with traditional spine surgery. You should be able to go back to your life as soon as you leave the clinic. Painkillers may be prescribed to treat initial pain and discomfort. Make sure you observe how your body responds to surgery. While most patients feel better right after the procedure, always be careful and share any doubts you might have with your doctor.

    Also remember to avoid any strenuous activity or heavy lifting for about 6 weeks after the procedure. Then, you can resume your regular workout routine.

    Right after surgery, you will be recommended physiotherapy and rehabilitation, a very important step after this type of surgery! At KCM Clinic, you will be followed by Dr. Krzysztof Suszyński, a specialist in physiotherapy, who will supervise your physiotherapeutic treatment before and after the procedure.

    Treatment information

    1. Endoscopic spine surgery (ESS, endoscopic spine surgery)

    is now a highly advanced and undoubtedly state-of-the-art form of minimally invasive spine surgery. This technique allows the patient to have a much faster recovery time and faster pain relief than traditional open spine surgery methods.
    Endoscopic spine surgery also helps to preserve the spine’s normal range of motion after surgery, which is especially important, especially in younger patients who want to quickly return to health and sports activities. Often, the procedure can be performed using regional anesthesia instead of general anesthesia, which significantly reduces overall medical risks in older patients or those burdened with other diseases.

    2. What is the main difference between endoscopic spine surgery and other types of spine surgery?

    Endoscopic spine surgery, in the experienced hands of a spine surgery specialist, offers patients many potential benefits, including:
    – the endoscopic procedure is performed by microdissection, a technique that reduces the need to incise skin tissue and the spinal muscles (less perioperative trauma)
    – less blood loss
    – much less postoperative discomfort and pain
    – short hospital stay (1 day)
    – rapid convalescence and short healing time

    3. What are the indications for endoscopic spine surgery?

    Endoscopic spine surgery is mainly indicated in chronic refractory spinal pain syndromes when diagnosed with degenerative spine disease, so-called “discopathy” and treatment of disc herniation. However, this technique may not be suitable for other indications for spinal surgery, such as scoliosis, spinal trauma or instability, and cancer. In such cases, based on the results of specialized tests like an MRI or CT scan of the spine, the surgeon may recommend a different type of surgery – traditional open or minimally invasive but not endoscopic.

    4. Is endoscopic spine surgery safe?

    Advances in medical technology and optical technology have allowed the development and development of an extremely modern and even revolutionary technique of endoscopic spine surgery.
    In the hands of a highly skilled and experienced surgical specialist, the potential benefits of this extremely minimally invasive endoscopic surgical technique can provide pain relief and highly effective treatment for today’s generation of patients suffering from chronic spinal pain syndromes.

    5. Benefits of endoscopic spine surgery vs. its risks

    As always and with any type of spine surgery, also with endoscopic techniques, there are benefits and risks associated with the operation. Therefore, it is extremely important to weigh with your surgeon all of your personal potential benefits and individual risks associated with treating your spine disease with an endoscopic spine surgery procedure during your consultation after a thorough diagnosis and discussion of your findings.
    Among the most important benefits is the small incision of the surgical site, which causes less trauma to the skin, muscles and soft tissues and results in less blood loss and a shorter recovery time with faster recovery. Most endoscopic procedures can be performed in about one hour, allowing the patient to be up and running more quickly , who can often be on their feet just a few hours after the procedure.
    Potential risks: Endoscopic spine surgery is a highly specialized surgical skill, and relatively few spine surgeons have the experience and sufficiently large number of procedures performed and perform these procedures regularly to be proficient.
    Endoscopic spine surgery is generally not suitable for revision surgery, in patients with pronounced spinal instability, high-grade spondylolisthesis or in cancer.
    Spine surgery specialists at KCM Clinic are among the most experienced in Poland and Europe, and KCM Clinic organizes international scientific and training conferences with LIVE transmission from the operating room in the field of endoscopic and minimally invasive spine surgery.
    Patient stories
    FAQ

    Spinal surgery – questions

    Are you a candidate for spinal surgery using the endoscopic technique?

    Common spinal conditions that may be an indication for endoscopic spine surgery include so-called disc disease, moderate or severe intervertebral disc herniation, facet arthropathy, recurrent sciatica as well as spinal canal stenosis.
    Spinal disease must be diagnosed not only on the basis of the patient’s history and clinical examination, but also confirmed by diagnostic imaging (MRI, CT scan).
    However, it should be emphasized that spine surgery should not always be the first course of treatment. As a rule, it is recommended that other types of non-surgical treatment (drug therapy and rehabilitation), be tried before any type of surgical treatment of the spine, including endoscopic spine surgery.

    How is endoscopic spine surgery performed?

    The endoscopic procedure is generally performed under local anesthesia or analgosedation. After being placed on the operating table, the patient is prepared for the procedure, with a local anesthetic administered to block pain. Through a skin incision under scopic control, a so-called working trocar, or rigid tube, is inserted into the operated area. Access to the spine, depending on the patient’s specific diagnosis and the doctor’s choice of technique, can be through the so-called intralaminar access (from the back of the spine between two plates) or transforaminal access (transforaminal from the back/lateral side of the spine).
    A thin endoscope ending in a tiny camera is then inserted through the trocar into the targeted area of the spine undergoing surgery. Through the endoscope, microsurgical instruments are inserted with which the surgeon operates. Throughout the endoscopic operation, the camera captures and displays real-time, very high quality images of the operated area on a monitor, watched by the surgeon. The endoscopic camera with visualization of the surgical field assists the surgeon during the operation, and when the operation is complete, all instruments, the camera and the endoscope with the trocar are gently removed. The skin incision is sutured and a small dressing is applied.

    How does endoscopic spine surgery work?

    Endoscopic minimally invasive spine surgery is performed using a general or local anaesthetic. In both cases, you will not feel any pain as the treated area will be completely numb.

    The first step of the procedure consists of making a 15-millimetre incision and introducing an endoscope. A dilator will be used to keep the incision open. This will allow the surgeon to see live images of the inside of the spinal canal. The main objective of the procedure is to try to remove the herniated vertebral disc tissue with the help of forceps. This is performed from the inside of the herniated disc, so the risk of damaging the spinal cord is drastically reduced. This will help relieve any compressed nerves. In addition, with this technique, it is possible to introduce medication more directly, as it’s easier to reach the areas where pain is located. At the end of the procedure, all instruments are removed and the incision closed.

    The duration of an endoscopic minimally invasive spine surgery is typically between 30 minutes and 1 hour.

    How do you prepare for endoscopic spine surgery?

    If you think endoscopic spine surgery might help or if your doctor has suggested this procedure, get in touch with us. One of our patient coordinators will get back to you to ask you questions about your current health and explain how the procedure works in detail. In order to assess your eligibility for endoscopic spine surgery, you will need to send us an MRI or CT scan of your spine, performed within the last 6 months. Make sure you pack your test results with you when you visit our clinic, including the CD. The test description alone is not sufficient.

    You will be informed whether you need to perform other medical tests; this will be assessed by our neurosurgeon, Dr. Stanisław Kwiek, who will also perform the procedure. Once you’re admitted to KCM Clinic, you will also have an anesthesiological consultation. You will most likely stay at our clinic for two days. Please also consider that you won’t be able to drive a car for some time after surgery. We offer pick-ups and drop-offs to and from the airport to all our international patients to make your experience on site as worry-free as possible!

    Post-surgery: How’s recovery like after endoscopic spine surgery?

    Usually, the patient is admitted in the morning, and during the same morning the operation is performed. The next day, the patient can go home wearing a lumbar corset.

    Overall, recovery is faster than with traditional spine surgery. You should be able to go back to your life as soon as you leave the clinic. Painkillers may be prescribed to treat initial pain and discomfort. Make sure you observe how your body responds to surgery. While most patients feel better right after the procedure, always be careful and share any doubts you might have with your doctor.

    Also remember to avoid any strenuous activity or heavy lifting for about 6 weeks after the procedure. Then, you can resume your regular workout routine.

    Right after surgery, you will be recommended physiotherapy and rehabilitation, a very important step after this type of surgery! At KCM Clinic, you will be followed by Dr. Krzysztof Suszyński, a specialist in physiotherapy, who will supervise your physiotherapeutic treatment before and after the procedure.

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