Dr. Jho's Minimally Invasive Lumbar Disc Herniation surgery: Lumbar Microdiscectomy or Endoscopic Lumbar Discectomy: Lumbar Disc Operation: Low Back Surgery

Overnight surgery

Hae Dong Jho, M.D., Ph.D.

Facts About This Surgery

• Is accomplished through a skin incision approximately 1.5 to 2 cm in length
• Utilizes an endoscope (a surgical microscope in the past) for enhanced visualization
• Patients can often be discharged the morning after surgery
• Patients are often able to return to work in 4 to 6 weeks

Discussion

Patients who have a herniated lumbar disc, and suffer from back pain and pain in one or both legs and have not received benefit from conservative measures such as physical therapy, may be a candidate for lumbar microdiscectomy or endoscopic lumbar discectomy. Under general anesthesia the surgeon places a trocar, which is a small tube for surgical access through which surgical instruments are passed, and then utilizing an endoscope (the operating microscope in the past) removes the herniated lumbar disc. The surgical incision is small and often only measures 1.5 to 2 cm in length. Patients are usually able to go home the day of their surgery, however, they are kept in the hospital overnight. Recovery is often quick and patients usually return to work in 4 to 6 weeks.

Definitions

discectomy - refers to removal of herniated vertebral disc

Images

A surgical trocar (1.5 cm in diameter, but 1-cm-trocar is used for a slender patient), placed in a patient's back, provides operative access during endoscopic lumbar discectomy.

This photograph exhibits positioning of patient during endoscopic lumbar discectomy as well as the placement of a surgical trocar (1.5 cm in diameter) through which the surgical procedure is completed.

             

Minimally invasive, yet adequate access is provided by a sterile syringe barrel (2 cm in diameter) in an extremely overweight patient (left). Lumbar discectomy taking place through a trocar, either under an operating microscope (in the past) or with an endoscope (now) (right).  

             

Two examples of a surgeon's magnified view during discectomy. The herniated disc is demonstrated at the tip of a suction cannula. The arrow indicates the compressed nerve root (left). The herniated disc is removed and the nerve root is decompressed (arrows, right).

A measuring tape discloses size of surgical incision following microdiscectomy. The surgical incision is covered with a smalll bandage (arrow). This operation was performed under an operating microscope, but now is performed with an endoscope. The use of an endoscope makes lumbar disc surgery much less invasive.