Orthopédie

Le guide ultime des instruments de chirurgie mini-invasive de la colonne vertébrale (MISS) : Maîtriser le PELD et le PESS avec Camjoy

Endoscope transforaminal pour la colonne vertébrale

The Ultimate Guide to Spine Endoscopy Instruments

Everything you need to know about PELD, PESS, and the precision tools that make them possible. A technical deep-dive for modern neurosurgeons.

1. The Rise of Minimally Invasive Spine Surgery (MISS)

The transition from open laminectomy to Endoscopic Spine Surgery represents one of the most significant advancements in orthopedics. Traditionally, treating a herniated disc involved dissecting large muscle groups, removing significant bone (lamina), and retracting nerve roots—all of which contributed to postoperative pain and instability.

Percutaneous Endoscopic Lumbar Discectomy (PELD) changes this paradigm. By utilizing a keyhole incision (< 8mm) and a targeted approach, surgeons can remove the pathology while preserving the multifidus muscle and the structural integrity of the spine.

Why Visualization Matters: In open surgery, the surgeon looks from a distance of 30-40cm. In endoscopic surgery, the Spine Endoscope places the surgeon's "eye" directly at the pathology, magnifying the nerve root and disc material by 20-30x on a 4K monitor.

2. Anatomy of a Spine Endoscope

A spine endoscope is not just a camera; it is a complex multi-channel device. Understanding its construction is key to choosing the right tool.

2.1 The Optical System

Camjoy scopes utilize a Rod Lens System (unlike the fiber bundles used in flexible scopes). Glass rods transmit the image with minimal loss of brightness or resolution.

  • Sapphire Window: The distal tip is sealed with sapphire glass, which is scratch-resistant against bone contact.
  • Light Fibers: Surrounding the rod lens are high-transmission optical fibers that carry light from your LED Light Source to the surgical field.

2.2 The Working Channel

This is the "tunnel" through which all instruments pass. The eccentricity of the working channel is designed to maximize space.

  • Standard Channel (3.7mm): Used in Transforaminal scopes for standard forceps.
  • Large Channel (4.3mm+): Used in Interlaminar scopes to accommodate large burrs and punches.

3. Transforaminal vs. Interlaminar Systems

There is no "one size fits all" in spine surgery. Camjoy offers two distinct systems tailored to specific surgical approaches.

[INSERT IMAGE: TRANSFORAMINAL VS INTERLAMINAR SCOPE COMPARISON]

3.1 Transforaminal Endoscopic Surgical System (TESSYS Style)

The Lateral Approach. This is the classic PELD approach. The scope enters through the intervertebral foramen.

ParameterSpecification
Direction of View (DOV)30°
Outer Diameter6.3mm / 7.5mm
Working LengthLonger (~205mm) to reach from the flank.
Best ForL1-L5 Disc Herniations, Foraminal Stenosis.

3.2 Interlaminar Endoscopic Surgical System (iLESSYS Style)

The Posterior Approach. Used when the iliac crest blocks the lateral entry (L5-S1) or for central canal stenosis.

ParameterSpecification
Direction of View (DOV)30° (Wide Angle)
Working ChannelExtra Large (>4mm) to allow rapid fluid outflow.
Working LengthShorter (~170mm) as the lamina is closer to the skin.
Best ForL5-S1 Herniations, Ligamentum Flavum Hypertrophy.

4. Essential Hand Instruments

The success of the surgery depends on the mechanical quality of the graspers and punches. Camjoy instruments are crafted from high-grade hardened stainless steel.

4.1 Nucleus Forceps (Graspers)

Designed to grab and remove the herniated nucleus pulposus.

  • Straight Forceps: For disc material directly in front of the scope.
  • Curved Forceps: To reach around the corner of the annulus.
  • Serrated Jaws: Essential for gripping the slippery, fibrous disc material.

4.2 Kerrison Rongeurs (Punches)

The most critical tool for bone resection (Laminectomy/Foraminoplasty). Camjoy offers a Detachable Design.

Why Detachable? Biological debris (bone dust, blood) can get trapped in the sliding rail of the punch. Our detachable mechanism allows you to separate the top and bottom rails for 100% cleaning efficacy, reducing the risk of cross-contamination.

4.3 Articulating (Flexible) Forceps

Sometimes the pathology is "hiding" behind the nerve root. Articulating forceps have a dial on the handle that curves the tip up to 90 degrees, allowing safe retrieval of fragments from the axilla zone.

5. Advanced Energy: Bipolar RF & Drills

5.1 Bipolar Radiofrequency (RF) Electrodes

In a fluid environment, standard monopolar cautery is dangerous and ineffective. Camjoy Trigger-Flex RF Probes use bipolar energy.

  • Hemostasis: The plasma field instantly seals epidural veins.
  • Tissue Ablation: Vaporizes soft tissue at lower temperatures (40-70°C) than standard cautery, protecting the nerve root.
  • Annuloplasty: Used at the end of surgery to shrink the annulus hole.

Models available: E4014090A (90° tip), E3912040B (40° tip).

5.2 Endoscopic Bone Drills

For stenosis, bone must be removed. We offer:

  • Diamond Burrs: Grind bone into fine dust. Safe to use near the dura.
  • Carbide Cutting Burrs: Aggressive bone removal for the initial laminotomy.

6. Sterilization & Maintenance Protocols

Protecting your investment is crucial. Spine endoscopes are delicate.

Step-by-Step Cleaning Guide

  1. Pre-Cleaning (In O.R.): Immediately flush the working channel with distilled water. Do not let blood dry.
  2. Manual Cleaning: Disassemble all detachable instruments. Use the long cleaning brush to scrub the inside of the scope channel.
  3. Ultrasonic Cleaning: ONLY for solid metal instruments (forceps, punches). NEVER put the optical endoscope in an ultrasonic cleaner—it will shatter the rod lenses.
  4. Sterilization:
    • Autoclave: 134°C (273°F) for 5-18 minutes. Use a dedicated tray with silicone fingers to hold the scope secure.
    • Plasma / ETO: Recommended for maximizing the lifespan of the optics.

7. Why Choose Camjoy?

For years, hospitals were forced to pay premium prices for German or American brands. Camjoy disrupts this model.

  • ISO 13485 Certified: We adhere to the strictest medical manufacturing standards.
  • Open Architecture: Our systems are compatible with Universal Camera Heads and light cables (Storz/Wolf adapters included).
  • Complete Solution: From the Tower (Monitor, Camera, Pump) to the smallest RF Probe, we supply it all.

Ready to Start Your PELD Program?

Get a customized quote for a complete Spine Tower or individual instrument sets.

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