First, the patient is prepped for surgery including administration of a local anesthetic to block pain. A 1-inch or smaller skin incision is made and a tubular trocar (about the width of a pencil) is inserted. Depending on the patient’s specific diagnosis, the endoscopic technique may access the spine using one of two approaches: either an intralaminar (from the back of the spine between two laminae) or transforaminal (from the back/side of the spine into the neuroforamen; a nerve passageway) approach.
Next, a tiny camera is inserted through the trocar to the targeted area of the spine. Throughout ESS, the camera captures and projects real-time images of the operative site onto a monitor in the surgeon’s direct view. The endoscopic camera assists and guides the surgeon during the surgical procedure.