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Simple working sheath for lumbar and lumbosacral spine: technical note
  1. Deepak Kumar Jha1,
  2. Jaskaran Singh Gosal1,
  3. Jigish Ruparelia1,
  4. Nitin Kumar1,
  5. Tarunesh Sharma1,
  6. Pradeep Kumar Bhatia2,
  7. Pushpinder Khera3
  1. 1 Department of Neurosurgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India
  2. 2 Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  3. 3 Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Deepak Kumar Jha, Neurosurgery, All India Institute of Medical Sciences Jodhpur, Jodhpur 342005, India; drdeepakjha{at}

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Summary box

What are the new findings?

  • A working sheath with basic and simple design which can be used for spine endoscopic surgeries is presented.

  • The endoscope used in this working sheath is the most commonly available (4 mm by 18 cm 0° rigid telescope) and is used by various other surgical disciplines such as otolaryngology, gynaecology and so on.

How might it impact on healthcare in the future?

  • The authors feel that there are ample opportunities for learning the skills of endoscopic spine surgeries during and after neurosurgical training, but the cost of commercially available endoscopic spine surgery equipment is quite high so that most public sector hospitals in developing countries cannot afford it.

  • Basic surgical instruments used for conventional spine surgery and which are available in other disciplines, such as camera, light source and monitors, are used with the simple working sheath, which can be used with any endoscope system.

  • In addition to its use in endoscopic spine surgeries, this working sheath can also be used with an operating microscope.


Endoscope-assisted lumbar and lumbosacral surgeries through the posterior approach have become common over the last two decades or more, especially in the removal of prolapsed discs and canal stenosis.1–4 Most of these systems have their own telescopes, and the commonly available 4 mm by 18 cm 0° rigid telescope and instruments used for conventional surgeries can rarely be used with these systems.1–4 Many centres in a developing country like India cannot procure these systems due to financial constraints.5–7 The authors share their experience of using a simple working sheath, which is compatible with a 4 mm by 18 cm 0° rigid telescope and with instruments used for conventional spinal surgeries, for microscopic or endoscopic lumbar and lumbosacral discectomies through the posterior approach.

Technical details

The working sheath was designed and made by the senior author (DKJ) using surgical grade stainless steel tubes of 15–17 cm in length (figure 1). The …

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  • Contributors Concept and design: DKJ. Literature research: DKJ, JSG, JR, NK, TS. Clinical studies: DKJ, JSG, JR, NK, TS, PKB, PK. Photographic data: DKJ, JSG, JR, PKB, PK. Manuscript preparation: DKJ, JSG. Manuscript editing: JR, NK, TS, PKB, PK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Patent application titled 'Universal Working Sheath for Micro Endoscopic Assisted Surgeries of Lumbar and Lumbosacral Spine' has been submitted to the office of the Controller General of Patents, Designs & Trade Mark, New Delhi, India (application no. 201711041209 A).

  • Provenance and peer review Not commissioned; externally peer reviewed.