1.2. Instruments for BESS/UBE

Previous section: Principles and concept of biportal endoscopic spine surgery (BESS/UBE)

1. Specialized BESS/UBE instrument set (optional).

The contents of a specialized set depend on the manufacturer; some instruments are selected separately. The set may include Kerrison punches, rongeurs, and discotomes of various types and sizes.

2. Telescopic dilator set.

3. Kerrison punches.

• Straight; working tip width 2 mm; angle 45°.

• Straight; working tip width 3 mm; angle 45°.

• Reverse; working tip width 3 mm; angle 90°.

• Rotating; working tip width 2 mm; angle 45°.

• Rotating; working tip width 3 mm; angle 45°.

4. Rongeurs.

• Straight with large jaws.

• Up-angled with large jaws.

• Up-angled with small jaws.

5. Discotome.

A medium-sized straight discotome for working within the intervertebral disc.

6. Nerve root retractor.

7. 3 mm curette.

8. Elevator.

9. Endoscopic annulotomy knife (Indian knife).

10. Osteotomes (chisels).

• Straight osteotome.

• Left hockey-stick osteotome.

• Right hockey-stick osteotome.

• Osteotome angled upward at 30°.

11. Mallet.

References

1. Choi CM, Chung JT, Lee SJ, Choi DJ. How I do it? Biportal endoscopic spinal surgery (BESS) for treatment of lumbar spinal stenosis. Acta Neurochir (Wien). 2016;158(3):459–463. https://doi.org/10.1007/s00701-015-2670-7

2. Park DK, Weng C, Zakko P, Choi DJ. Unilateral biportal endoscopy for lumbar spinal stenosis and lumbar disc herniation. JBJS Essent Surg Tech. 2023;13(2):e22.00020. https://doi.org/10.2106/JBJS.ST.22.00020

3. Choi CM. Biportal endoscopic spine surgery (BESS): considering merits and pitfalls. J Spine Surg. 2020;6(2):457–465. https://doi.org/10.21037/jss.2019.09.29

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