Introduction

Good day!

Over the past few decades, we have all seen previously unknown people (bloggers), through the rapid growth in the popularity of social media, become opinion leaders on many issues in every area of our lives. I myself follow young medical bloggers on social media who attract audiences of hundreds and, without sufficient experience, tell us categorically how patients should be treated.

Before moving on to the main part of this work, I would therefore like to introduce myself and demonstrate my expertise in endoscopic spine surgery.

My name is Iakiv Fishchenko, and I work as a spine surgeon at the National Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine in Kyiv.

In 2017, I became interested in endoscopic spine surgery and introduced its methods into my practice. For almost 2 years, I performed uniportal endoscopic spine surgery using MaxMoreSpine instruments. In early 2019, at an endoscopic surgery seminar in Turkey, among a dozen presentations on uniportal endoscopy, I happened to hear a presentation on the new method of biportal endoscopy. It was the last presentation, and most of the audience had already left. Like many other attendees, I asked myself: why use 2 portals when everything can be done through one? Yet the next day, in the operating room, I saw the surgeon at work firsthand and became deeply fascinated by this method. Since then, I have completed several fellowships in Turkey and South Korea. I have observed and spoken with outstanding endoscopic spine surgeons, and I was the first in Ukraine to introduce biportal endoscopy into my own practice.

Today, we have the greatest experience in biportal endoscopic spine surgery in Ukraine: each year, we perform more than 400 endoscopic surgical procedures. Since 2017, I have personally performed over 3000 endoscopic spine operations.

We perform endoscopic procedures throughout the spine: from the first cervical vertebra to the sacrum, for all degenerative conditions and, in selected cases, for inflammatory and traumatic spinal conditions. Over these years, we have gained invaluable experience: alongside practical skills, we have developed a rehabilitation system for these patients, introduced ERAS protocols, and learned to prevent and manage complications.

Biportal endoscopic spine surgery (BESS/UBE) combines continuous video visualization with freedom to manipulate instruments through two small access sites. In lumbar discectomy, spinal stenosis, and mild degenerative spinal deformities, randomized trials have confirmed advantages over microsurgery: less muscle trauma, less pain at the surgical wound site during the first days after surgery, and better scar quality, with comparable outcomes in pain relief and functional recovery.

I created this atlas for surgeons learning and refining the BESS/UBE technique. Step-by-step explanations, videos, and clinical examples help organize the learning process. Mastering the technique involves specialized training, cadaver courses, mentorship, and progressively staged practical work in accordance with local protocols.

We would like to share all of this experience with you in this interactive atlas, which we plan to improve and expand online.

I invite you into this wonderful world of biportal spinal endoscopy!

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