Mr of ths case

Access to disc

COURSE OF WORKING CANNULA

INTERSPINALIS

MULTIFIDUS LONGISSIMUSILIOCOSTALIS

QUADRATUS LUMBORUM

PSOAS MAJOR

Transforaminal surgery

midline

Disc space as is seen

Lateral marking

Lateral c arm

Lordosis considered

Same distance from midline

Point of entry

LA

Needle trajectory

AP

Lateral

On entry ap

On entry LAT

Guide wire ready

Remove needle

Dialtor over guide wire

Dilator at intertrans area

Dilator in disc centre ap

Dilator in disc lat

Cannula on dialtor

Cannula in disc below fragment

Cannual seen in lateral

Scope and grasper in cannula

First glimpse

Removal of herniation

fragment

Grasper seen on c arm

Skin cut less than 8 mm

System USP

• Size• Ease of use• Minimalism in instruments• Evolution and version 3