Endoscopic spine surgery is the most minimally invasive spine surgery (MISS) technique available. This type of surgery treats back pain caused by nerve compression, such as disc herniations, spinal stenosis and synovial cysts.
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During these procedures, your surgeon makes a small incision – often as small as ¼ inch – in your back. They will thread a pen-size tube, called a dilator, gently retracting your back muscles to gain access to the bones of your back (vertebrae). They then slide a long, thin tube (an endoscope) through the dilator to get a better look at your problem area. Finally, your surgeon will use a small, high-definition camera and other small, specialized tools through the endoscope to repair your spine.
For you, that means less pain and a faster recovery. In fact, most patients can leave the hospital within two-to-three hours after surgery.
Endoscopic spine surgery techniques are often faster, typically lasting one to two hours. Recovery time is also typically shorter, so you can get back to your regular exercise and work activities sooner. These procedures, when done by an experienced surgeon like those at UW Medicine, can also provide several other benefits, including:
Purpose: The aim of this study was to describe the surgical method of endoscopic conjunctivodacryocystorhinostomy with Jones tube insertion using a Castroviejo double-ended lacrimal dilator and to elucidate the surgical outcomes.
Methods: Under general anesthesia and preoperative epinephrine soaking, a monopolar needle cautery instrument was used to remove the nasal mucosa over the lacrimal and maxillary bone junction. After the lacrimal and maxillary bone junction was exposed, an oval osteotomy was formed. A Castroviejo double-ended lacrimal dilator was then inserted to create a direct fistula from the conjunctiva to the nasal cavity through the bony ostium. The dilator was grasped and withdrawn using smooth forceps to determine the tube length. The selected tube was then inserted into the fistula with a guide probe. Following removal of the probe, the inserted tube was fixed with 7-0 Ethilon suturing.
Results: Among 39 patients, a total of 49 cases were examined. The success rate was 73.4% (36/49 eyes). The average surgical time was 29.1 minutes for single-eye operations and 47.3 minutes for double-eye operations. Lateral migration (6/13; 46.2%), medial migration (3/13; 23.1%), granulation tissue obstruction (2/13; 15.4%), inflammation (1/13; 7.7%), and malpositioning (1/13; 7.7%) were the noted complications that led to reoperation.
Conclusions: In conclusion, surgical management of endoscopic conjunctivodacryocystorhinostomy using a Castroviejo double-ended lacrimal dilator has several advantages. Using this device, easier surgical procedure, shorter surgical time, and more favorable success rate can be achieved without serious complications.
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