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
