As you know, the original spinal endoscopic technique originated from the SED (Selected endoscopic discectomy) technique of Dr. Anthony Yeung YESS system in the U.S. It can be said to be the origin of the targeted technique, which is often referred to as the YESS technique.What are the characteristics of the YESS (SED) technique? Features of the YESS technique: According to Dr. Yeung’s own description, selective (selected) endoscopic disc removal is to be performed depending on the different herniated features. The concept is that the disc tissue is removed by entering the disc and then retreating into the spinal canal to remove the free disc tissue. The practical application is as follows Zhang Xifeng, Department of Orthopedics, Beijing 301 Hospital From the diagram, it can be seen that the central axis of the working channel is parallel to the vertebral space. The initial point of contact between the puncture needle and the spine is the intersection of the line connecting the adjacent vertebral arches, and the horizontal line of the center of the intervertebral disc. The central point of puncture is at the center of the nucleus pulposus, or slightly posterior to it. The concept is: Insintde-out technique, which translates to “intra-disc, then intra-canal”, a technique where the disc is first removed and then the canal is removed. The TESSYS technique was introduced by Dr. Hoogland in Germany and is characterized by a 30-45 degree angle between the puncture needle and the disc level in the coronal plane. In the sagittal plane the puncture needle has an angle of 45-55 degrees to the horizontal line. The initial point of contact of the puncture needle with the spine is the tip of the articular eminence on the inferior vertebral body. Intervertebral foraminoplasty is performed regardless of age. This is referred to as the outside-in technique, which translates to “extradiscal, then intradiscal”. This is a technique in which the free disc is removed from the spinal canal first, and then the disc is removed from within the spinal canal. The Easy Technique ET technique is a modified YESS technique that was developed in practice after studying YESS and TESSYS, and has the characteristics of both methods. Features: “Simplicity” and “Variety”. Advantages: fast, accurate, and wide. Disadvantages: Variation, takes longer for young doctors to learn and master. The concept is: Margin or Face to margin of posterior ligment, which translates to “margin” or “face to margin of posterior longitudinal ligament”, a technique that places the working surface at the margin of the posterior longitudinal ligament. Technique. Simple technique procedure: 1. Simple position Prone position with lumbosacral lordosis excluded. Either a folded surgical bed or an X-ray permeable posture pad can be used. It is not necessary to have an expensive brand-name surgical bed or postural frame. 2.Simple fluoroscopy procedure There are no special cases, only orthoptic fluoroscopy is performed. The minimum number of fluoroscopies is two, and the number of fluoroscopies is usually limited to six. From the number of fluoroscopies, you can see the doctor’s level of mastery of the technique. (If you read this article before surgery, you can silently count the number of fluoroscopies during your surgical procedure, which will partially reflect the doctor’s ability to master the fluoroscopy technique). Because fluoroscopy machines are radioactive, although the radiation exposure is very small, there is a limit to the amount of radiation a doctor who performs this procedure on a daily basis can receive each year. There is an annual state radiation allowance and annual leave for radiologists. Orthopedic surgeons do not According to the Korean physician Ahn literature reports: without the use of lead aprons, a doctor can do 291 PELD procedures. Which patient is unlikely to receive 291 PELD procedures, so the amount of radiation as a patient undergoing PEDL surgery is negligible. Dr. Ahn reported the time of their surgery is 49.8 minutes, the time of fluoroscopy is 2.5. According to the length of each fluoroscopy 0.6 seconds, his each fluoroscopy to reach 225 exposures. Our procedure is based on 4-10 fluoroscopies, a mere 2.4-6 seconds of exposure time. It is not to show off the short X-ray exposure time, it is to show the advantages of the simplex technique. In contrast, fluoroscopy of about 100 times is a regular occurrence for the techniques characterized by foraminoplasty. 3.Simple anesthesia procedure Using 1% lidocaine, only the nociceptive nerve is anesthetized, and no motor nerve is affected. During the operation, the patient’s pain disappears and the motor function is normal, so he or she can cooperate with the surgeon to complete the operation. 4.Simple surgical procedure According to the principle of “facing the posterior longitudinal ligament” approach, combined with the patient’s intraoperative nerve monitoring, the simple protruding, upward and downward free disc and fiber ring fragments can be removed as quickly as possible. With the cooperation of special instruments, cases of herniated calcified discs and spinal stenosis can be completed. 5, simple postoperative treatment According to national regulations, PELD surgery has not belonged to the perioperative use of antibiotics. After several hundred cases of trial, we have completely abandoned the practice of using antibiotics in the perioperative period. We use only painkillers or/and dehydrating drugs in the perioperative period. 6. Simple inpatient surgery process The process of day surgery with the simple technique is illustrated with an out-of-town patient as an example. Step 1: Register on, upload medical history, symptoms, signs, and clear imaging data. Step 2: Receive a positive response and set a time to come to Beijing for consultation. Step 3: Arrive at Beijing Capital International Airport or Beijing West Station, Beijing Station, Beijing East Station (mainly for freight), Beijing South Station, Beijing North Station by plane or train every Thursday morning. Then take a clearly marked mostly Hyundai cab towards the PLA General Hospital in Wukesong, West 4th Ring Road. Coming from the Capital International Airport is around 120-140 RMB, and the other train stations will not exceed that. If it’s more than that, it’s huh, you know. Step 4: Go to the registration room of the old outpatient building to register a general orthopedic number first, then go to the second floor after 2pm to the 28th consultation room to give authorization for an additional number. Go to any registration window after you get the information that you are sure to add a number, and add one of my specialist numbers. You can then see the nurse at the surgery clinic to shabu-shabu the number, and then go to the 28th clinic to listen to the call notice. Step 5: You will be seen in the consultation room, and the diagnosis will be determined based on the information you bring, and the next treatment plan will be decided based on the severity of your condition. If the condition is not serious, you can go home knowing the conservative treatment plan; or you can continue traveling. If the condition is slightly severe, you will be referred to a non-surgical unit for consultation. If the condition is severe, a hospitalization certificate and various pre-operative tests will be issued. If needed, ask for a consultation with various related departments for pre-operative preparation. Step 6: Send the inpatient certificate to the inpatient department in the basement to receive a return receipt for the inpatient certificate. Some patients who were issued a hospitalization certificate took it to their home in Shanxi and then told me that the inpatient office never notified them of their hospitalization. As a reminder, the inpatient office does not have a telepathic function with everyone. Step 7: Our inpatient process is very fast, and we can usually have inpatient surgery within a week after the inpatient card is issued, so we recommend that you do not go far. And you should complete the outpatient examination items prescribed in time to avoid the embarrassment and trouble of finding out that you have paid the outpatient fee after hospitalization and have not yet had your blood drawn, and then you have to refund the fee. Step 8: Be sure to remember what kind of surgical treatment you will receive after hospitalization. If it is determined to be a minimally invasive procedure, be prepared to be discharged the same day. Remember that the post-operative follow-up is 3 months, 6 months, 1 year, and 2 years. If symptoms are severe, feel free to contact. If the condition is stable you can contact us at the specified time. The contact method is to continue uploading the film on for follow-up. It is possible not to come to the outpatient clinic for review, for the convenience of patients from out of town, except for patients from Beijing. Patients who are not treated by me can consult in the Zhang Xifeng Lumbar Bulge Visitors Group. Both groups have our doctors on duty, or senior synaptists as moderators, to do their best to provide reasonable and sensible guidance to everyone. All patients entering the groups must be authenticated with their real names; anonymous consultations are not welcome and are regularly purged. The purpose of the real name system is to facilitate the determination of everyone’s condition, otherwise people this much can not be right. May all patients find the right treatment for themselves!