Han In Ho, Choi Byung Kwan, Cho Won Ho, Nam Kyoung Hyup
Department of Neurosurgery & Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
J Korean Neurosurg Soc. 2012 Mar;51(3):182-6. doi: 10.3340/jkns.2012.51.3.182. Epub 2012 Mar 31.
In conventional percutaneous disc surgery, introducing instruments into disc space starts by inserting a guide needle into the triangular working zone. However, landing the guide needle tip on the annular window is a challenging step in endoscopic discectomy. Surgeons tend to repeat the needling procedure to reach an optimal position on the annular target. Obturator guiding technique is a modification of standard endoscopic lumbar discectomy, in which, obturator is used to access triangular working zone instead of a guide needle. Obturator guiding technique provides more vivid feedback and easy manipulation. This technique decreases the steps of inserting instruments and takes safer route from the peritoneum.
在传统的经皮椎间盘手术中,将器械插入椎间盘间隙是从将导针插入三角形工作区开始的。然而,在内镜下椎间盘切除术(endoscopic discectomy)中,将导针尖端置于环形窗口(annular window)是一个具有挑战性的步骤。外科医生往往会重复穿刺操作,以在环形靶点(annular target)上达到最佳位置。闭孔器引导技术(Obturator guiding technique)是标准内镜下腰椎间盘切除术的一种改良方法,其中,使用闭孔器进入三角形工作区,而不是导针。闭孔器引导技术提供了更清晰的反馈且操作简便。该技术减少了器械插入步骤,并从腹膜(peritoneum)处采用了更安全的路径。