Applications of multifunctional trocars in spine surgery
A great advantage of multifunctional trocars is the possibility of careful transmuscular access to the spine from the dorsal side: the metal trocar has an external screw thread. After a skin incision of about 10 mm and dissection of the lumbar-dorsal fascia with a blunt obturator, the trocar is inserted into the musculature and screwed in.
This technique corresponds to the traditional habitual way of working with paramedial fenestration, but is significantly more gentle, since muscle retraction, ischemia, and also scarring as a result of the expander pressure do not appear. Patients do not lose mobility and have less pain.
Another advantage is that due to the lateral percutaneous approach during the introduction of the endoscope, the working field and the field of view are not limited in any way, as well as when fixing the endoscope within the working channel in competing instruments. This method makes it possible for simultaneous endoscopic assistance and works with a microscope, which significantly reduces the time it takes to familiarize yourself with this system.
Also, orientation and recognition of anatomical structures are improved by working with 0 ° optics. According to the indications, the expected situation, and the patient's build, there are two different trocar diameters 11mm and 15mm, and 2 working lengths 5cm and 7cm to choose from. Thanks to the percutaneous port at the end of the intervention, it is possible to drain according to Redon without any difficulty.
All in all, it is an ideal microendoscopic system and is very easy to maintain. Finally, the system can be conveniently used in conjunction with the optional retainer without the assistance of an assistant.