Disruptive solution of endoscope in orthopedic spine diagnosis and treatment

1、 Revolutionary breakthrough in minimally invasive spinal surgery

(1) Endoscopic Spinal Surgery (FESS)

Technological disruption:

Percutaneous single channel technique: Complete intervertebral disc resection with a 7mm incision (traditional open surgery requires a 5cm incision).

Visual circular saw system (such as Joimax TESSYS): Accurately polish bone spurs to avoid nerve damage.

Clinical data:

(2) UBE (Unilateral Dual Channel Endoscopy) technique

Technical advantages:

Establish a 12mm observation channel and an 8mm operation channel to achieve an "open surgical like operating space".

Suitable for lumbar spinal stenosis, the decompression range is three times larger than that of a single channel.

Innovative equipment:

Radiofrequency ablation bipolar electrocoagulation (such as ArthroCare Coblation): precise hemostasis while protecting nerve roots.

(3) Endoscopic assisted spinal fusion (Endo LIF)

Technological breakthrough:

By implanting a 3D printed fusion device (with a porosity of 80%) through Kambin triangulation, the bone growth rate was increased by 40%.

Combined with O-arm navigation, the accuracy of nail placement is 100% (traditional fluoroscopy is about 85%).

2、 The paradigm upgrade of arthroscopic technology

(1) 4K Ultra HD Arthroscopy System

Technical highlights:

The Sony IMX535 sensor provides a resolution of 10 μ m, increasing the detection rate of meniscus tears to 99%.

Like Shi Lehui's 4K Insight system, it supports HDR display of synovial vascular morphology.

(2) Robot assisted arthroscopy

MAKO Orthopedic Robot:

Submillimeter level precise osteotomy (error 0.1mm), with a force line deviation of less than 1 ° after total knee replacement surgery.

In 2023, JBJS research showed that the 10-year survival rate of prostheses has increased from the traditional 90% to 98%.

(3) Biological enhanced remediation technology

Endoscopic bone marrow stimulation+PRP injection:

After microfracture in the cartilage defect area, platelet rich plasma (PRP) was injected, and the thickness of fibrocartilage regeneration reached 2.1mm (traditional methods only 0.8mm).

Absorbable collagen scaffold implantation: such as Geistlich Cholro Gide, sutured and fixed under the microscope.

3、 Minimally invasive solutions for trauma and sports medicine

(1) Endoscopic repair of Achilles tendon

Technological innovation:

Dual channel endoscopy (such as Arthrex SpeedBridge) completes percutaneous weaving and suturing, with a strength 30% higher than open surgery.

The postoperative recovery time has been shortened from 12 weeks to 6 weeks.

(2) Endoscopic release of carpal tunnel syndrome

MicroAire system:

Cut the transverse ligament of the wrist with a 3mm incision, with a surgical time of less than 5 minutes.

The median nerve injury rate has decreased from 3.5% in traditional methods to 0.2%.

(3) Full endoscopic repair of rotator cuff injury

Knotless suture technique:

Use FiberTape with loop steel plate (such as Arthrex SwiveLock), with a tensile strength greater than 500N.

The re tear rate has decreased from 20% in open surgery to 8%.

4、 Intelligent and Navigation Technology

(1) AR Navigation Endoscopy System

Technical implementation:

Microsoft HoloLens 2 overlays CT data to display real-time pedicle screw paths.

Beijing Jishuitan Hospital data: The accuracy rate of nail placement is 100%, and the number of X-ray exposures is zero.

(2) AI intraoperative decision support

Deep learning algorithms:

The Johnson&Johnson VELYS system automatically adjusts the range of meniscus resection based on joint movement trajectory.

Reduce operation time by 25% to avoid excessive resection.

(3) Pressure sensing endoscopic instruments

SmartDrill：

Real time monitoring of drilling pressure, automatically stopping rotation when penetrating the anterior cortex of the vertebral body (error<0.1mm).

5、 Future technological directions

Nano arthroscopy:

The 1mm diameter magnetic mirror developed in Switzerland can enter the interphalangeal joint.

Self repairing intelligent implants:

Shape memory alloy stent expands at body temperature to correct scoliosis.

Digital Twin Surgery Preview:

Simulate endoscopic procedures on the metaverse platform based on patient CT data.

Clinical Benefit Comparison Table

Implementation strategy suggestions

Grassroots hospitals: equipped with UBE dual channel system, covering 80% of lumbar degenerative diseases.

Sports Medicine Center: Building a 4K arthroscopy+biotherapy platform.

Research focus: Developing biodegradable magnesium alloy endoscopic implants (such as fracture fixation screws).

These technologies are pushing orthopedic surgery towards the "ultra minimally invasive era" through their three core advantages of "sub centimeter incisions, zero damage to anatomical structures, and immediate functional recovery". It is expected that by 2028, 60% of spine and joint surgeries will be completed through natural channels or incisions below 5mm.