Thoracoscopic, laparoscopic, endoscopic, “through the scope”, minimally invasive? These terms describe recently popularized approaches to spine surgery. In order to understand how these approaches may have a role in your spinal surgery, the terminology must be understood.
An endoscope is an instrument used for the examination of a hollow viscus such as the bladder or a cavity such as the chest. The endoscope is basically a camera mounted on a long thin lens with a cable and a light source. The light source is mounted onto the lens and provides light to illuminate the field to be visualized. The cable mounted on the camera connects to a TV screen, which displays the camera’s field of focus.
Endoscopy, Thoracoscopy, Laparoscopy
Endoscopy is the visual inspection of any cavity or hollow viscus by means of an endoscope. Thoracoscopy is the visualization of the thoracic cavity or the chest. Thoracoscopy is used to assist in procedures on the heart and lungs. Laparoscopy is the visualization of the abdominal cavity. Laparoscopy is used to assist in procedures on the intestines, stomach, or removal of the gallbladder.
What is the purpose of utilizing the endoscope? The endoscope allows the surgeon to have an illuminated and magnified view of the operating field without having to make a large incision. With the assistance of the endoscope surgeons can utilize several small incisions to perform the same procedure they would otherwise perform using a single large incision.
Laparoscopic and thoracoscopic surgery are not new techniques. Dr. Jacobaeus was the first to publish his work in 1910 on both of these topics. In the 1980’s laparoscopic cholescystectomy or removal of the gallbladder became very wide spread. However, it was not until the early 1990’s when the application of these techniques became utilized in the field of spinal surgery. Early uses were for biopsy, removal of thoracic disc herniations and releasing or mobilizing the anterior spine for scoliosis and kyphosis. The applications rapidly expanded to many aspects of spinal surgery.