ENDOSCOPIC FUSION OF THE LUMBAR SPINE

For certain indications, anterior fusion of the lumbar spine is a stan dard operation. The surgeon specializing in operations on the vertebra l column needs to learn to utilize the advantages of laparoscopic surg ery. However, an absolute must before employing the technique in patie nts is adequate training in its use in living animals. For this purpos e, the pig is a highly suitable model. The surgical team comprises a s urgeon experienced in spinal procedures, an abdominal surgeon with ski lls in laparoscopic surgery and an experienced camera assistant. In th e animal model and in clinical trials, a change in position - organ pr eparation from the cranial direction, a suprasymphysial approach to th e vertebrae - has proved expedient. The use of a special instrumentati on for maintaining the pneumoperitoneum, for protecting the spinal cor d and for exact centering, including the application of a special dowe l (ESKA-spacer and instruments) is essential. The greater technical ef fort may be expected to result in shorter hospitalization (2-3 days) i n the future.