6.2. Equipment and Instruments
@ProfFishchenkoIn my practice, I use the equipment and instruments listed below for BESS/UBE decompression of central and lateral recess stenosis in the lumbar spine. Independent viewing and working portals allow endoscopic visualization to be combined with conventional spinal instruments.
Equipment
1. Radiolucent operating table with a Wilson frame.
2. C-arm.
3. Endoscopic tower: monitor; video system—console and camera; light source and light cable; 0° endoscope; 30° endoscope (optional).
4. Gravity-fed irrigation system without a pump: two 3 L saline bags. I maintain continuous free outflow through the working portal. Further details: §2.4 “Irrigation and Establishing Fluid Outflow”.
5. Stryker CORE 2 system with a powered instrument handpiece: 5 mm cutting burr; Tomcat, Aggressive Plus, and other shaver blades. I select attachments according to compatibility with the specific system.
6. BONSS ARS600 radiofrequency generator: RF electrode with a 5 mm working tip; RF electrode with a 1.5 mm working tip (optional). Working settings and instructions for use are given in §2.6 “Hemostasis”.
7. Suction system and irrigation fluid collection system.
Instruments
1. Specialized BESS/UBE instrument set.
2. Dilator set.
3. Kerrison punches: 3 mm working tip width; 45° angle.
4. Curved Kerrison punches.
5. Rongeurs.
6. Nerve root retractor.
7. Elevator.
8. Osteotomes (chisels): straight and angled at 30°.
9. Mallet.
Preoperative checks
Before surgery, I check component compatibility and the function of cables, connections, the foot pedal, and the suction system. I separately check fluid inflow and the availability of free outflow. When working with the C-arm, we use radiation protection and personal dosimeters.
Photographs of equipment and instruments
Photographs and a detailed description of the standard set are provided in the general part of the atlas:
§1.2. Instruments for Biportal Endoscopic Spine Surgery
§1.3. Equipment for Biportal Endoscopic Spine Surgery
References
1. 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. DOI: 10.2106/JBJS.ST.22.00020.
2. 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. DOI: 10.1007/s00701-015-2670-7.
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