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J Neurol Surg A Cent Eur Neurosurg 2019; 80(04): 291-301
DOI: 10.1055/s-0039-1677825
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Practical Aspects and Avoidance of Complications in Microendoscopic Spine Surgeries: A Review

Yad Ram Yadav
1   Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India
,
Angelo Lucano
2   Department of Neurosurgery, Hospital S. Croce and Carle Cuneo, Carle Cuneo, Italy
,
Shailendra Ratre
1   Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India
,
Vijay Singh Parihar
1   Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India
› Author Affiliations
Further Information

Publication History

24 May 2018

19 November 2018

Publication Date:
09 April 2019 (online)

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Abstract

Introduction Although the indications for endoscopic procedures have increased in recent times, there are also some limitations. This review discusses the practical points to prevent and treat complications in microendoscopic spine surgery.

Material and Methods A literature search was conducted for the relevant articles after a topic search on PubMed, Google Scholar, and Medline. The review is based on the experience of 1,574 spinal endoscopic procedures performed by the senior author.

Results Advantages of endoscopic surgery include better visualization, panoramic vision, and the ability to work around corners. Limitations with endoscopic procedures include proximal blind areas, obstruction in instrument handling due to a narrow corridor, disorientation, frequent lens fogging, loss of depth perception, and difficulty in achieving hemostasis, leading to complications and longer operative time during the learning curve.

Conclusion Surgeons need to learn endoscopic skills in addition to microsurgical ones to perform microendoscopic procedures properly. Attending live workshops, watching operative videos, visiting various departments, watching an experienced and accomplished endoscopic surgeon, proper case selection, a multidisciplinary team approach, practicing on models, hands-on cadaveric workshops, laboratory training, and simulators can improve results and shorten the learning curve.

Keywords

complication - endoscopic surgical procedure - minimal invasive - procedure - neuroendoscopy - training program
 

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