The YESS Selective Endoscopic Discectomy ™ technique is a minimally invasive spine surgery used to treat extruded, protruded, herniated or degenerative discs that are causing you back and leg pain. This endoscopic procedure is performed with a tiny surgical light and camera to allow the surgeon to see, so he can keep the incisions small.
Smaller incisions lead to less tissue trauma, less post-operative pain and quicker recovery times. Moreover, in this surgery, you can avoid general anesthesia, reducing your risks.
Your surgeon performs this minimally invasive procedure through a small tubular device that he inserts into a small incision. This technique relieves pain caused by a herniated disc pressing on a root nerve.
Since you are given local or epidural anesthesia, you can return to your own home to recover after this same-day surgery. Talk to your spine surgeon at the Southeastern Spine Institute (SSI) about your risks and recovery expectations.
1. Inserting the Guide Wire
You must lie on your back on an X-ray table. After the surgeon confirms your disc protrusion, as shown in the top left illustration, he inserts a guide wire through a small incision all the way to the affected disc. See illustration 1. He uses a fluoroscope, which displays live X-ray images, to make sure the route to the herniated disc is correct.
2. Inserting the Obturator
Your doctor then passes a two-hole obturator tube, shown in illustration 2, over the guide wire to push apart your tissue to access the disc and to move the root nerve out of the way. As needed, he anesthetizes painful tissue in the path of the obturator.
3. Inserting the Working Sleeve
The working sleeve, through which your doctor will perform the surgery, slides over the dilating tube. The surgeon positions it on the disc surface, as shown in illustration 3. The doctor then removes the guide wire and obturator.
4. Inserting the Endoscope
Your surgeon places an endoscope — containing a surgical light and small camera — through the sleeve so he can view the bones, the disc and the epidural space. He uses the endoscope, which shows live images on a video monitor, to guide the surgical tools to the disc and inspect the results of his work. See illustration 4.
5. Removing the Degenerative Disc Portions
The surgeon removes the degenerative and extruded bits of your disc nucleus, as shown in illustration 5. Because only enough of the disc is removed to reduce pressure inside the disc, your spine remains stable. Once he removes these disc pieces, it lessens the pressure on your root nerve, reducing your pain.
6. Treating the Disc Wall
Your doctor treats the disc wall defect with a laser and radiofrequency probe. The heat cauterizes the break and repairs the wall. The surgeon inspects the nerve and the foramen, where the nerve exits the spine, to confirm that he successfully removed the obstruction. Then he removes the instruments and sleeve.
7. Recovering from the Procedure
The surgeon covers the insertion point in your skin with a small bandage. You need a day of bed rest after the procedure and then you will likely start physical therapy. You most likely can return to normal activity within one to six weeks.