Thessys (Thomas Hoogland Endoscopic Spinal System)

Introduction

To date Dr. Hoogland has performed more than 15.000 spine surgical procedures, of which more than 12.000 were minimally invasive. His publications include more than 25 scientific articles, some of them chapters in edited scientific books. Additionally, Dr. Hoogland has made more than 100 presentations at Interventional congresses and  has organised  several congresses.

1991 Dr. Thomas Hoogland collected first experiences with Spinal Foraminoscopy in close coperation with Hal Matthews, M.D. and Danek Inc. The image was of poor quality but mechanical dimensions matched anatomical requirements because auf length (210 mm) and working channel diameter of 3.7 mm for use of 3.5 mm surgical instruments and devices.

1994 Dr. Hoogland specified a set of surgical instruments consisting of guide wire, dilators, operation cannulas and trephines to enlarge the foramen intervertebralis and rongeurs and forceps for removal of extruded disc material. He cooperated with German OEM producers for surgical instruments.

1998 Dr. Hoogland cooperated with Blazejewski MEDI-Tech, a German based small sized but innovative OEM producer for Endoscopes and Visualization Systems. By Dr. Hoogland Specifications a series of pathbreaking Endoscopes has been developed and produced.

2000 To promote his operation technique (Thessys) and related Endoscopic Equipment joi-max GmbH was founded by Reinhold Blazejewski, Thomas Hoogland M.D., and Wolfgang Ries. Dr. Hoogland delivered his know-how portfolio about herniated disc treatment, device specifications, international network of spinal surgeons, experience in workshop organization and congress presentations and his OEM connections for production. He also spended an amount for company formation and got shares oft he company. Reinhold Blazejewski delivered his excellent knowledge in Endoscope- and Visualization development.

2004 Dr. Hoogland resigned his contract with joi-max by unknown reasons and founded 2006 his own company max-more Hoogland Spinal Products GmbH. Dr. Hoogland improved the access instruments and added patented reamers for boney work and widening oft he foramen intervertebralis. (Tom-Shidi Instruments)

Material and Method

In order not to irritate any nerve root close to the foramen and to ensure a safe access to the spinal canal, the caudal part of the foramen is widened millimeter by millimeter with specially designed reamers. Via the posterolateral approach to the foramen intervertebralis the injection needle is guided to the dorsal facet joint and the anesthetic is injected. Afterwards the guide wire is inserted and the injection needle removed. Then soft tissue is dilated. By the Tom shidi needle the facet joint is prepared so that the first reamer is anchored and unable to slide into the spinal channel causing injuries. Then the foramen is widened step wise. Afterwards drill is removed and then the dilator and operation sleeve is placed over the remaining guidewire. After removal of the guidewire and dilator the Foraminoscope is introduced into the operation sleeve.  With resection instruments the leaked disc material is removed under direct vision from the outside of the annulus to the base. (outside-inside technique). Thereafter it is endoscopically checked that all fragments are removed and the nerve root is decompressed.

Endoscope Specification (1998)

Length: 180 and 210 mm

Working Channel: 3.7 mm

Rod lens optical system: 1.9 mm rod lenses

Dual irrigation channel

Fiber light illumination (cold light source)

30° direction of view

Outer diameter of the scope 6.3 and 5.9 mm

Remarks

Because of reduction of the rod lenses diameter to 1.9 mm the working channel could be enlarged to 3.7 mm for use of 3.5 mm surgical instruments and devices.

In 2004 Richard Wolf followed with similar specifications and in 2012 also Karl Storz.

Progress:

3.7 mm working channel by 5.9 mm outer diameter of the scope.

Patended access and drill instruments

Through the development of surgical instruments and endoscopes in collaboration with German OEM manufacturers the range of indications for minimally invasive treatment of spinal disorders has been significantly expanded.