Joimax’s TESSYS intervertebral foramina technique is an “outside-in” technique. Using the patented, uniquely designed intervertebral foramina and corresponding surgical instruments from Joimax, the patient enters the intervertebral foramina from the side or side and back of the body, and the surgery is performed in the working triangle, with the working trocar placed in the epidural space, below the nerve root, so that damage to the nerve root can be avoided. The working trocar is not placed in the intervertebral space, and a complete set of surgical instruments uniquely designed by Joimax is used from outside the annulus fibrosus of the intervertebral disc to remove the protruding nucleus pulposus tissues under direct endoscopic vision, and then use the Trigger-Flex bipolar technology, uniquely designed by the American ellman company, which is designed for the dual-frequency radiofrequency machine that can be used to control the length and angle of bending, to ablate the residual tissues, to stop the hemorrhage and to close the broken tissue by using the principle of local heat contraction. The principle of local heat contraction is used to close the broken fiber ring. During the procedure, the patient is fully awake and the doctor and patient can communicate with each other. The surgery can be performed in the lateral or prone position, depending on the situation. The procedure is simple and can take less than an hour, and the patient can be discharged from the hospital the same day after the surgery. Compared with other current minimally invasive spinal nucleus pulposus removal techniques, TESSYS is more indicative, less invasive, less damaging, more effective, and faster to recover. Indications of intervertebral foramenoscopy 1 .It is suitable for various types of lumbar disc herniation (extreme lateral herniation and prolapse type, free type, huge type, ossification formation, etc.). 2, Recurrence of disc herniation after open surgery. 3. Intervertebral foraminal stenosis (hyperplasia, cohesion of the small joint protrusion, hypertrophy and subsidence of the lateral ligamentum flavum). Advantages of TESSYS technology 1. Intervertebral foramenoscopy is a particularly gentle surgery, giving the patient as little physical trauma and mental stress as possible. It is currently the most minimally invasive surgical treatment, with direct surgical objectives and complete decompression. 2, local analgesia: the patient stays awake, TESSYS uses local anesthesia, the operation time is about 1 hour, the patient always stays awake, in the state of analgesia, the pain is slight or feel no pain. Compared to general anesthesia, the patient can immediately inform the surgeon if he or she has pain during the procedure, which means that nerve damage is virtually non-existent. What’s more, local anesthesia does not have the risks and potential damage to the body of general anesthesia and is inexpensive. Patients feel comfortable during and after surgery, eliminating the fear of surgery. Especially for elderly patients and patients with cardiovascular disease, disc removal is also no longer a problem. Local anesthetic drugs are absorbed and decomposed through the tissues rather than through the liver and kidneys. 3. The surgery removes only the part of the tissue that is herniated and causing clinical symptoms, and there is no damage to the surrounding tissues, so the stability of the spine is not affected. Usually, you can be discharged from the hospital on the same day after surgery. Minimal trauma: The skin incision is only 7.5mm, avoiding the need for wide and deep tissue stripping, and replaced by step-by-step catheter dilatation. The muscles and connective tissues around the spine are not damaged, making the surgery almost “bloodless”. Scarring, wound and muscle pain is minimal, and the minor scarring is anterior, with no adhesions to the spinal canal or nerves posteriorly. The chance of infection is very low. 5. Through the intervertebral foraminal approach, rather than the posterior approach of traditional surgery, the nerves and spinal canal can be visualized but not disturbed. There is no need to strip the muscles and ligaments during the operation, and there is no need to bite off the vertebral plate, which does not destroy the stability of the spine; after the operation, no scar tissue will be formed to cause neural adhesion, and the after-effects and complications are extremely low. 6, fast recovery: the United States Cleveland Clinical Foundation study confirmed: the use of intervertebral foramenoscopy treatment of patients, 3 to 6 weeks to recover; while the traditional surgery requires 3 to 6 months. TESSYS technology, the success rate of 90% or so, the recurrence rate is low (only 5%), the use of other surgical modalities, the figure of 10% to 12%. 7, the equipment used not only to complete minimally invasive surgery, but also to take into account some of the needs of the field of pain management. For example, the radiofrequency machine used in this system can do “radiofrequency ablation”, i.e., IDET, which is mainly used for nerve destruction of discogenic pain, in parallel with fibroplasty, and, if necessary, it can also do intradiscal nucleus pulposus ablation; 1.2mm electrodes can be used to do cervical spinal spine ablation and part of the target point ablation.