UBE (Unilateral Biportal Endoscopy) surgery is a unilateral double-channel endoscopic surgery, and visual trepanation has an important application in UBE surgery.
1. Basic principles and characteristics of visual trepanation
Principle
Visual trepanation combines endoscopic visualization technology with the cutting function of traditional trepanation. It can provide a clear surgical field of view during surgery through a built-in optical system, allowing doctors to observe the location of trepanation cutting and the condition of surrounding tissues in real time.
Its working principle is similar to that of traditional trepanation, which cuts tissues through a rotating circular saw blade, such as when dealing with bony structures such as lamina and articular processes.
Features
High accuracy: Compared with non-visual traditional instruments, visual trepanation can accurately locate the cutting site. For example, in spinal UBE surgery, when part of the lamina needs to be removed for decompression, the visual trepanation can accurately control the depth and range of cutting to avoid damage to important structures such as the spinal cord and nerve roots.
Improved safety: Since it can be observed in real time, doctors can adjust operations in time according to the tissue conditions seen. For example, when encountering blood vessels or other important soft tissue structures close to the cutting area, the cutting path can be changed in advance or the operation can be suspended to reduce the probability of surgical complications.
2. Application in various links of UBE surgery
Decompression link
In spinal canal decompression surgery, the visual ring saw is used to remove structures such as the lamina and yellow ligament. For example, in the UBE surgical treatment of lumbar spinal stenosis, the lamina can be accurately removed by the visual ring saw to create enough space for the nerve structure in the spinal canal and relieve the symptoms of nerve compression.
It can accurately grind and remove the hyperplastic bone. For example, when dealing with the situation of bone hyperplasia caused by spinal degeneration compressing the nerve, the visual ring saw can remove the hyperplastic bone at a suitable angle and depth without causing excessive damage to the surrounding normal bone tissue and nerves.
Fusion link (if applicable)
In some steps of spinal fusion surgery, the visual ring saw can be used to deal with parts such as facet joints. Accurately remove part of the facet joint to create a suitable space for implants such as fusion devices, and ensure the accuracy of the implant placement during the operation, because a good field of vision can help doctors determine whether the space is appropriate and whether the surrounding tissues are clean.
3. Advantages and limitations of the application
Advantages
Improved surgical effect: The surgical operation can be completed more accurately, thereby improving the success rate of the operation. For example, in nerve decompression surgery, due to precise cutting, the nerve decompression is more sufficient, and the patient's postoperative neurological function recovery may be better.
Shortened operation time: Precise operation reduces the time for repeated adjustment of instrument position and correction of incorrect cutting. For example, during laminectomy, the visual trephine can achieve the ideal cutting effect at one time, which may save a certain amount of surgical time compared to traditional instruments.
Limitations
High equipment cost: The manufacturing process of the visual trephine is complex and includes precision parts such as endoscopes, which makes it expensive and increases the equipment cost of the operation.
High technical requirements: The surgeon needs to master both endoscopic technology and trephine operation technology. Doctors need to undergo special training to be proficient in using the visual trephine for surgery, otherwise they may not be able to give full play to its advantages and even increase surgical risks.
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