TY - JOUR T1 - Simple working sheath for lumbar and lumbosacral spine: technical note JF - BMJ Innovations JO - BMJ Innov SP - 478 LP - 481 DO - 10.1136/bmjinnov-2020-000558 VL - 7 IS - 2 AU - Deepak Kumar Jha AU - Jaskaran Singh Gosal AU - Jigish Ruparelia AU - Nitin Kumar AU - Tarunesh Sharma AU - Pradeep Kumar Bhatia AU - Pushpinder Khera Y1 - 2021/04/01 UR - http://innovations.bmj.com/content/7/2/478.abstract N2 - Summary boxWhat 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.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 … ER -