1995 Volume 47 Pages 94-97
We report laparoscopic lumbar discectomy, developed and established by us through animal experiments, from the viewpoint of surgeons who applied laparoscopic surgery to orthopedics. Laparoscopic surgery practiced by surgeons occupied an important place in the development of operation field and exposure of intervertebral discs. L5-S was reached by abdominal approach, and L2-5 exposed by extraperitoneal approach.
The operation procedure was as follows : surgeons developed the operation field under pneumoperitoneum, and exposed the intervertebral disc. Orthopedists then took over and performed discectomy and fusion (bone graft) . Subsequently, surgeons closed the field, repairing retroperitoneum, etc, with which the operation was finished. With the intervertebral disc in front view and magnified, the operation was safe and easy for skilled orthopedists for spinal surgery. Gasless laparoscopy was used in orthopedic part of the operation because carbon dioxide embolism at osteotomy under pneumoperitoneum could interfere with fusion. We think this technique compares favorably with a procedure being tried in the US in respect to the safty and therapeutic effect. The technique of laparoscopic lumbar discectomy and fusion are described.
