Thoracoscopy, laparoscopy and endoscopy are all terms used to describe a range of ‘minimally invasive’ approaches to surgery. The endoscope allows the surgeon to have a magnified and illuminated view of the site of the operation without making a large incision.
Early uses of endoscopic procedures were for biopsy, removal of thoracic disc herniations and releasing or mobilizing the anterior spine for scoliosis and kyphosis.
Currently, a relatively small number of spinal surgeries can be performed utilizing an endoscopic approach. The incisions for endoscopic surgery are usually a centimetre in length, through which a portal is established to maintain cavity space for passage of surgical instruments to the site of disc damage.
In the thoracic spine the space through which to operate is provided by deflating the lung. The anaesthetist places a special breathing tube down the trachea into the large airway of each lung. Once in place the patient breaths using only one lung, allowing the opposite lung to deflate and move away from the spine. The portals are placed and the procedure to be performed on the spine is begun.
Endoscopic surgery allows smaller incisions and possibly a reduction in the amount of tissue dissected, reducing post-operative pain and improving recovery.