9.2. Equipment and Instruments
@ProfFishchenkoIn my practice, I use standard BESS/UBE equipment and the additional instruments listed below for contralateral endoscopic decompression of the lumbar intervertebral foramen.
Equipment
• A radiolucent operating table with a Wilson frame.
• A C-arm.
• A monitor and video system: console and camera.
• A light source and light cable.
• Gravity irrigation without a pump: two 3 L bags of normal saline. In my usual setup, their lower edge is approximately 170 cm above the floor. This describes bag position, rather than a prescribed pressure. We continuously maintain free outflow; we do not compensate for impaired outflow by raising the bags.
• A Stryker CORE 2 console and handpiece.
• A spherical or barrel-shaped 5 mm cutting burr.
• A 5 mm shaver tip, including Tomcat or Aggressive Plus.
• A 0° scope; a 30° scope if needed.
• A BONSS ARS600 radiofrequency generator.
• A 5 mm RF electrode; a 1.5 mm RF electrode if needed.
• A suction system.
Instruments
• A specialized BESS/UBE instrument set.
• A dilator set.
• Kerrison rongeurs with 2 and 3 mm working widths, 45° angle.
• Rongeurs: straight and upturned.
• An elevator.
• Osteotomes (chisels): straight and curved at 30°.
• A surgical mallet.
Photographs and descriptions of the standard equipment are provided in the sections «Instruments for BESS» and «Equipment for BESS».
References
1. Akbary K, Kim JS, Park CW, Jun SG, Hwang JH. Biportal endoscopic decompression of exiting and traversing nerve roots through a single interlaminar window using a contralateral approach: technical feasibilities and morphometric changes of the lumbar canal and foramen. World Neurosurg. 2018;117:153-161. doi:10.1016/j.wneu.2018.05.111.
2. Tian D, Zhu B, Liu J, Chen L, Sun Y, Zhong H, et al. Contralateral inclinatory approach for decompression of the lateral recess and same-level foraminal lesions using unilateral biportal endoscopy: a technical report. Front Surg. 2022;9:959390. doi:10.3389/fsurg.2022.959390.
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