1.3. Equipment for BESS/UBE
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1. Radiolucent operating table with a Wilson frame.
2. C-arm.
We use radiation protection equipment and personal dosimeters when working with the C-arm.
3. Endoscopy tower.
• Monitor.
• Video system: console and camera.
• 0° endoscope.
• 30° endoscope (optional).
• Light source and light cable.
• Shaver console and handpiece.
• Spherical or barrel-shaped cutting burr, 5 mm.
• Tomcat, Aggressive Plus, and other shaver blades.
A foot pedal may reduce the risk of unintended activation; the control method is selected according to the system design and the manufacturer’s instructions.
4. Gravity irrigation.
For irrigation, I use gravity-fed saline without a pump, maintaining continuous free outflow through the working portal.
5. Radiofrequency generator.
• RF electrode with a 5 mm working tip.
• RF electrode with a 1.5 mm working tip (optional).
To reduce the risk of thermal injury, I avoid prolonged continuous activation of the RF electrode and contact between its active part and neural structures.
6. Suction system and irrigation fluid collection system.
Preoperative check
Before surgery, I check component compatibility and the condition of cables, connections, pedals, and the suction system.
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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