Endoscopic surgery in the area of orthopedics has been evolving, particular
ly in spine surgery. We describe the clinical outcome of thoracoscopic ante
rior spine release using new instruments. A harmonic scalpel (HS) with a 5-
mm hook dissector was used to dissect the spine and rib and to coagulate an
d transect the vascular bundles. A rib dissector and resector were used for
excision of the rib to be implanted in the disk spaces. We treated scolios
is in four patients (three male, one female) with a mean age of 19.5 +/- 4.
5 years and thoracolumbar kyphosis in a 16-year-old male patient. A mean nu
mber of 6.5 +/- 2.5 vertebrae with scoliosis and four vertebrae with kyphos
is were released. Tn all cases, division of the vascular bundle and exposur
e of the spine were completed using only the HS, and excision of a rib segm
ent was performed via a port incision using only the rib dissector and rese
ctor. The mean duration of thoracoscopic anterior release was 92 +/- 28 min
. Blood loss was minimal during and after surgery. Thoracoscopic anterior s
pine release can be facilitated by the new instruments described above.