iLESSYS® – Interlaminar Endoscopic Surgical System
The endoscopic system for the treatment of disc herniations and spinal stenoses using the interlaminar window as access.
The iLESSYS® Family
In order to cover the full range of indications, localizations and patients, we offer iLESSYS® in different variants.
iLESSYS® provides everything you need to get started with interlaminar spinal endoscopy. The standard instrument set contains the complete set of instruments (e.g. grasping, cutting and punching forceps) for a safe minimally invasive access to the spinal canal and the removal of disc tissue, bone spurs or scar tissue.
- Broad range of instruments for safe minimally invasive access
- Various forceps, Vaporflex® and Vaporace® RF probes for removal of disc tissue
- Small size enables treatment of cervical indications also
- Widespread application opportunities
The iLESSYS® Pro system has been developed in collaboration with Dr. Christoph Hofstetter to advance the interlaminar technique allowing unilateral laminotomy for bilateral decompression (ULBD).
The instrument set offers additional flexibility and improved ergonomics over the standard instrument set. The longer endoscope provides increased reach for contralateral access, while the 15° viewing angle allows a more direct view into the spinal canal.
- Larger working channel for larger instruments for more efficient resection
- Still small enough to work within the spinal canal
- Flexible application for complex over-the-top technique
iLESSYS® Delta was developed based on input of numerous highly experienced endoscopic surgeons. It provides tools for a more comprehensive and efficient removal of bony structures over several levels.
The increased endoscope diameter enables the use of large-diameter instruments. This allows for more efficient removal of pathologic bone tissue, resulting in shorter operating times.
- Largest diameter of the working channel
- Extensive decompression with powerful Endo-Kerrision punches
- Efficient laminotomy with special Shrill®Diamond Shaver Blades
- Complemented by the Vaporace®RF probe
- For massive bony decompression at several levels
UNILATERAL BIPORTAL ENDOSCOPY (UBE) FOR THE TREATMENT OF MULTILEVEL DISEASES IN A BIPORTAL AND BIMANUAL MODE
With Unilateral Biportal Endoscopy a new contender is making waves in spinal endoscopy. The separation of the endoscopic and working channel allows endoscopic access with a maximum working range enabling the broadest field of interlaminar applications.
UBE is a beneficial treatment option for central stenoses, assisted interlaminar fusions and complication management (e.g. dural tears) located in the lower lumbar spine.
- Triangulation tool and tailored instruments for precise biportal access
- Large working tube with integrated valve for controlled unidirectional water flow
- Pressure and flow control with Versicon® irrigation pump
- For safe application and constant clear vision
Superior endoscope control at your fingertips –
The magnetic support arm for advanced spinal endoscopy
With the new RoboFIX® holding arm maintaining a set position, the surgeon is relieved of the weight of the camera, freeing both hands for optimal control. This not only improves ergonomics, but also makes complex maneuvers much easier. This is especially useful for complicated indications and when a second access port must be controlled, such as during unilateral biportal endoscopy.
Furthermore, RoboFix® expands surgical possibilities for biportal and especially for bimanual techniques. It functions as the surgeon’s third arm for controlled application of complex procedures and challenging instrument maneuvering.
The joimax® Approach
The iLESSYS® method uses the endoscopic interlaminar approach for the removal of herniated disc material or the treatment of spinal stenosis. This approach is less traumatic than the conventional microsurgical technique. Surgeons can choose between mono- and biportal endoscopic methods.
Compared to open or microscopic techniques, minimal soft tissue disruption is required due to the small diameter of the joimax® Laminoscopes®.
During the entire procedure, brilliant optics and constant irrigation ensure excellent visibility by continuously removing debris and bleeding from the surgical site.
Selected Indications
- Herniated intervertebral disc (protrusion, prolapse,
sequester and free fragment) - Spinal stenosis through soft and/or bone tissue
- Degenerative disease of the ligamentum flavum
- Cauda equina syndrome
- Facet joint cysts
Selected Indications
• Herniated intervertebral disc (protrusion, prolapse, sequester and free fragment)
• Spinal stenosis through soft and/or bone tissue
• Degenerative disease of the ligamentum flavum
• Cauda equina syndrome
• Facet joint cysts
joimax® offers complete and integrated solutions for minimally-invasive endoscopic spinal care.
In addition to the interlaminar uniportal systems – iLESSYS® Standard, Delta and Pro – a new interlaminar biportal system expands the range of applications.
For each interlaminar system, innovative and tailored instruments provide precise access and enable efficient removal of herniations, sequestered disc tissue, and hypertrophic tissue directly at the lamina as well as through the interlaminar window. Surgeons will benefit from excellent vision and ease of handling.
Innovative Solutions » Unique Benefits
- Smaller incision
- Less trauma/less scarring/better cosmesis
- Reduced blood loss
- Less pain
- Improvement of pain and mobility, improved quality of life
- Faster recovery time
The iLESSYS® Gallery
Disclaimers
Certain products may not be approved for sale in all countries.
Scientific Literature for iLESSYS®
[1] Clinical outcomes of MED and iLESSYS® Delta for the treatment of lumbar central spinal stenosis and lateral recess stenosis: A comparison study
Wu B, Xiong C, Tan L, Zhao D, Xu F, Kang H; Experimental Therapeutic Medicine (2020); 20:252-262
[2] The Endoscopic Trans-Superior Articular Process Approach: A Novel Minimally Invasive Surgical Corridor to the Lateral Recess
Hasan S, White-Dzuro B, Barber JK, Wagner R, Hofstetter CP; Oper Neurosurg (Hagerstown) 2020; 19: E1–E10
[3] Comparison of clinical outcomes following minimally invasive or lumbar endoscopic unilateral laminotomy for bilateral decompression
McGrath LB, White-Dzuro GA, Hofstetter CP; J Neurosurg Spine (2019): 1–9
- Zhou Y, Zhou C, Li Q, Cai L, Kou B, Fang W et al. Efficacy of PE-PLIF with a novel ULBD approach for lumbar degeneration diseases: a large-channel endoscopic retrospective study. Journal of Orthopaedic Surgery and Research 2024; 19 269.
- Leyendecker J, Sofoluke N, Hofstetter CP, Konakondla S. Full endoscopic resection of large bilateral synovial cysts in lumbar spine. Neurosurgical Focus: Video 2024; 10:V7.
- Kim JY, Hong HJ, Kim HS, Heo DH, Choi SY, Kim KM et al. Comparative Analysis of Uniportal and Biportal Endoscopic Transforaminal Lumbar Interbody Fusion in Early Learning Stage: Technical Considerations and Radiological Outcomes. J Minim Invasive Spine Surg Tech 2024. doi:10.21182/jmisst.2023.01032.
- Shen J, Park DK, Telfeian AE. Thoracic Spine Endoscopic Techniques. Seminars in Spine Surgery 2024; : 101085.
- Wang H-H, Xia D-D, Wu X-C, Hu B-W. [Unilateral interlaminar approach 270° circular spinal canal decompression under the iLESSYS Delta for the treatment of lumbar spinal stenosis in the elderly]. Zhongguo Gu Shang 2023; 36:1070–1074.
- Xu H, Yu L, Xiao B, Zhao H, Gu X, Gao Z et al. Comparison of outcomes between Endo-TLIF and MIS TLIF in patients with single-level lumbar degenerative disease: A retrospective study. World Neurosurgery 2023. doi:10.1016/j.wneu.2023.11.092.
- Kim HS, Wu PH, Jang I-T. Technical note on Uniportal full endoscopic posterolateral approach transforaminal lumbar interbody fusion with reduction for grade 2 spondylolisthesis. Interdisciplinary Neurosurgery 2020; 21:100712.
- Lin Y, Rao S, Li Y, Zhao S, Chen B. Posterior Percutaneous Full-Endoscopic Cervical Laminectomy and Decompression for Cervical Stenosis with Myelopathy: A Technical Note. World Neurosurgery 2019; 124:350–357.
- Saravi B, Zink A, Ülkümen S, Couillard-Despres S, Wollborn J, Lang G et al. Clinical and radiomics feature-based outcome analysis in lumbar disc herniation surgery. BMC Musculoskelet Disord 2023; 24 791.
- Sheng Y, Li J, Geng M, Fen J, Sun S, Sun J. Comparative analysis of the efficacy of delta channel and microscope-assisted fenestration in the treatment of lumbar intervertebral disc herniation: A 12-month retrospective cohort study. .
- Derman PB, Rogers-LaVanne MP, Satin AM. Collagen Matrix Inlay Graft for Management of Incidental Durotomy During Full-Endoscopic Lumbar Spine Surgery: Technique and Case Series. Int J Spine Surg 2023; 17:399–406.
- Ma H-J, Lee S-H, Park CH. Uniportal full endoscopic spinous process–preserving laminectomy for bilateral decompression in cervical stenotic myelopathy: patient series. Journal of Neurosurgery: Case Lessons 2023; 5. doi:10.3171/CASE2378.
- Wu D, Meng F, Chen T, Han Q, Qin R. Short-Term Patient Outcomes Using the Interlaminar Endoscopic Surgical System Ilessys® Delta System versus Bilateral Laminotomy: A Single-Center Study of 80 Patients with Degenerative Lumbar Spinal Stenosis. Med Sci Monit 2023; 29:e938477.
- Leyendecker J, Yap N, Prasse T, Eysel P, Bredow J, Hofstetter CP. Outpatient Full Endoscopic Cervical Unilateral Laminotomy for Bilateral Decompression with Virtual Postoperative Monitoring. J Minim Invasive Spine Surg Tech 2023. doi:10.21182/jmisst.2023.00710.
- Olinger C, Coffman A, Campion C, Thompson K, Gardocki R. Initial learning curve after switching to uniportal endoscopic discectomy for lumbar disc herniations. Eur Spine J 2023. doi:10.1007/s00586-023-07583-x.
- Sheng Y, Li J, Chen L, Geng M, Fen J, Sun S et al. Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study. BMC Musculoskelet Disord 2023; 24:43.
- Jiang Y, Li C, Yuan L, Luo C, Mao Y, Yu Y. Ultrasonic Osteotome Assisted Posterior Endoscopic Cervical Foraminotomy (PECF) in the Treatment of Cervical Spondylotic Radiculopathy Due to Osseous Foraminal. J Korean Neurosurg Soc 2022. doi:10.3340/jkns.2022.0233.
- Haijun M, Xiaobing Z, Bin G, Jinwen H, Dacheng Z, Shenghong W et al. Trans-interlamina percutaneous endoscopic cervical discectomy for symptomatic cervical spondylotic radiculopathy using the new Delta system. Sci Rep 2020; 10:10290.
- Yu Y, Jiang Y, Xu F, Yuan L, Mao Y, Li C. Percutaneous full-endoscopic uniportal decompression for the treatment of symptomatic idiopathic lumbar spinal epidural lipomatosis: Technical note. Front Surg 2022; 9:894662.
- Han S, Zeng X, Zhu K, Wu X, Shen Y, Han J et al. Clinical Application of Large Channel Endoscopic Systems with Full Endoscopic Visualization Technique in Lumbar Central Spinal Stenosis: A Retrospective Cohort Study. Pain Ther 2022. doi:10.1007/s40122-022-00428-3.
- Yao R, Yan M, Liang Q, Wang H, Liu Z, Li F et al. Clinical efficacy and learning curve of posterior percutaneous endoscopic cervical laminoforaminotomy for patients with cervical spondylotic radiculopathy. Medicine 2022; 101:e30401.
- Wu B, Xiong C, Tan L, Zhao D, Xu F, Kang H. Clinical outcomes of MED and iLESSYS® Delta for the treatment of lumbar central spinal stenosis and lateral recess stenosis: A comparison study. Exp Ther Med 2020; 20:1–1.
- Kim HS, Paudel B, Jang JS, Oh SH, Lee S, Park JE et al. Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis Through Uniportal-Contralateral Approach: Techniques and Preliminary Results. World Neurosurg 2017; 103:201–209.
- Wagner R, Telfeian AE, Iprenburg M, Krzok G. Minimally invasive fully endoscopic two-level posterior cervical foraminotomy: technical note. J Spine Surg 2017; 3:238–242.
- Saravi B, Zink A, Ülkümen S, Couillard-Despres S, Hassel F, Lang G. Performance of Artificial Intelligence-Based Algorithms to Predict Prolonged Length of Stay after Lumbar Decompression Surgery. J Clin Med 2022; 11:4050.
- Kim J, Lee DC, Kim TH, Park CK. Full Endoscopic Interlaminar Contralateral Lumbar Foraminotomy for Recurrent L5-S1 Foraminal-extraforaminal Stenosis: A Case Report with a Technical Note. J Minim Invasive Spine Surg Tech 2022. doi:10.21182/jmisst.2022.00528.
- Transforaminal Endoscopic Lumbar Microdiscectomy via Transforaminal Kambin’s Triangle Approach. Congress of Neurological Surgeons. 2022.https://www.cns.org/nexus/case/detail/transforaminal-endoscopic-lumbar-microdiscectomy-v (accessed 19 Jul2022).
- Bae J, Lee S-H, Wagner R, Shen J, Telfeian AE. Full Endoscopic Surgery for Thoracic Pathology: Next Step after Mastering Lumbar and Cervical Endoscopic Spine Surgery? BioMed Research International 2022; 2022:e8345736.
- Tan R, Lv X, Wu P, Li Y, Dai Y, Jiang B et al. Learning Curve and Initial Outcomes of Full-Endoscopic Posterior Lumbar Interbody Fusion. Front Surg 2022; 9:890689.
- Zhao X-B, Ma Y-J, Ma H-J, Zhang X-Y, Zhou H-G. Clinical Efficacy of Posterior Percutaneous Endoscopic Unilateral Laminotomy with Bilateral Decompression for Symptomatic Cervical Spondylotic Myelopathy. Orthop Surg 2022. doi:10.1111/os.13237.
- Kim HS, Wu PH, Kim J-Y, Lee YJ, Kim DH, Lee JH et al. Comparative Clinical and Radiographic Cohort Study: Uniportal Thoracic Endoscopic Laminotomy With Bilateral Decompression by Using the 1-Block Resection Technique and Thoracic Open Laminotomy With Bilateral Decompression for Thoracic Ossified Ligamentum Flavum. Oper Neurosurg (Hagerstown) 2022. doi:10.1227/ons.0000000000000145.
- Lee DC, Kim JY, Kim TH, Park CK. Unilateral approach with two-cage insertion for full endoscopic transforaminal lumbar interbody fusion: technical report. Acta Neurochir (Wien) 2022. doi:10.1007/s00701-022-05168-z.
- Bae J, Sathe AH, Lee S-H. Endoscopic decompression of L3 nerve root in a case of adult spinal deformity correction with post-operative neurological deficit: a case report. AME Case Rep 2022; 6:1.
- Shen J, Shaaya E, Bae J, Telfeian AE. Endoscopic Spine Surgery of the Cervicothoracic Spine: A Review of Current Applications. Int J Spine Surg 2021; 15:S93–S103.
- Youn MS, Shin JK, Goh TS, Lee JS. Full endoscopic lumbar interbody fusion (FELIF): technical note. Eur Spine J 2018; 27:1949–1955.
- Li Y, Dai Y, Wang B, Li L, Li P, Xu J et al. Full-Endoscopic Posterior Lumbar Interbody Fusion Via an Interlaminar Approach Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Preliminary Retrospective Study. World Neurosurgery 2020; 144:e475–e482.
- Carrascosa-Granada A, Velazquez W, Wagner R, Saab Mazzei A, Vargas-Jimenez A, Jorquera M et al. Comparative Study Between Uniportal Full-Endoscopic Interlaminar and Tubular Approach in the Treatment of Lumbar Spinal Stenosis: A Pilot Study. Global Spine J 2020; 10:70S-78S.
- Yu T, Wu J-P, Zhang J, Yu H-C, Liu Q-Y. Comparative evaluation of posterior percutaneous endoscopy cervical discectomy using a 3.7 mm endoscope and a 6.9 mm endoscope for cervical disc herniation: a retrospective comparative cohort study. BMC Musculoskelet Disord 2021; 22:131.
- Cheng Y, Zhang Q, Cheng X, Li Y, Chen X, Wu H. Comparative Study of the Percutaneous Endoscopic Interlaminar Approach and Transforaminal Approach in the Treatment of Calcified Lumbar Disc Herniation. In Review, 2021 doi:10.21203/rs.3.rs-761501/v1.
- Hofstetter CP. Atlas of Full-Endoscopic Spine Surgery. 2020.https://www.thieme.com/books-main/neurosurgery/product/5466-atlas-of-full-endoscopic-spine-surgery (accessed 6 Aug2021).
- Khalsa SS, Kim HS, Singh R, Kashlan ON. Radiographic outcomes of endoscopic decompression for lumbar spinal stenosis. Neurosurgical focus 2019; 46:E10.
- Middleton SD, Wagner R, Gibson JA. Multi-level spine endoscopy: a review of available evidence and case report. EFORT open reviews 2017; 2:317–323.
- Tacconi L, Spinelli R, Serra G, Signorelli F, Giordan E. Full-Endoscopic Removal of Lumbar Juxtafacet Cysts: A Prospective Multicentric Study. World Neurosurgery 2020; 141:e414–e422.
- Kim HS, Raorane HD, Wu PH, Heo DH, Sharma SB, Jang I-T. Incidental Durotomy During Endoscopic Stenosis Lumbar Decompression: Incidence, Classification, and Proposed Management Strategies. World Neurosurg 2020; 139:e13–e22.
- Hasan S, McGrath LB, Sen RD, Barber JK, Hofstetter CP. Comparison of full-endoscopic and minimally invasive decompression for lumbar spinal stenosis in the setting of degenerative scoliosis and spondylolisthesis. Neurosurg Focus 2019; 46:E16.
- Kong M, Gao C, Cong W, Li G, Zhou C, Ma X. Percutaneous Endoscopic Interlaminar Discectomy with Modified Sensation-Motion Separation Anesthesia for Beginning Surgeons in the Treatment of L5-S1 Disc Herniation. J Pain Res 2021; 14:2039–2048.
- Kim HS, Wu PH, Jang I-T. Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature. Int J Mol Sci 2020; 21:E1483.
- Wei H, Shunli K, Zehua J, Tengfei Z, Yidong L, Rusen Z. Comparative Study of Three Minimally Invasive Surgical Approaches for the Treatment of L5/S1 Lumbar Intervertebral Disc Herniation. Turk Neurosurg 2021; 31:324–332.
- Wu B, Xiong C, Tan L, Zhao D, Xu F, Kang H. Clinical outcomes of MED and iLESSYS® Delta for the treatment of lumbar central spinal stenosis and lateral recess stenosis: A comparison study. Exp Ther Med 2020; 20:252.
- McGrath LB, White-Dzuro GA, Hofstetter CP. Comparison of clinical outcomes following minimally invasive or lumbar endoscopic unilateral laminotomy for bilateral decompression. J Neurosurg Spine 2019; : 1–9.
- Wagner, Ralf, Telfeian, Albert, Krzol, Guntram, Iprenburg, Menno. Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note. Interdisciplinary Neurosurgery 2018; 13:6–9.
- Zhang J-J, Zhou C-L, Sun C, Xu D-R, Bao M, Liu Y. <p>Clinical Efficacy Study of the Quadrant Channel and Delta Large Channel Technique in the Treatment of Lumbar Degenerative Diseases</p>. International Journal of General Medicine. 2021. doi:10.2147/IJGM.S309272.
- Yang F, Ren L, Ye Q, Qi J, Xu K, Chen R et al. <p>Endoscopic and Microscopic Interlaminar Discectomy for the Treatment of Far-Migrated Lumbar Disc Herniation: A Retrospective Study with a 24-Month Follow-Up</p>. Journal of Pain Research. 2021. doi:10.2147/JPR.S302717.
- Yang F, Chen R, Gu D, Ye Q, Liu W, Qi J et al. Clinical Comparison of Full-Endoscopic and Microscopic Unilateral Laminotomy for Bilateral Decompression in the Treatment of Elderly Lumbar Spinal stenosis: A Retrospective Study with 12-Month Follow-Up. J Pain Res 2020; 13:1377–1384.
- Houle P, Telfeian AE, Wagner R, Bae J. Interspinous endoscopic lumbar decompression: technical note. AME Case Rep 2019; 3:40.
- Lee C-W, Yoon K-J, Ha S-S. Comparative Analysis between Three Different Lumbar Decompression Techniques (Microscopic, Tubular, and Endoscopic) in Lumbar Canal and Lateral Recess Stenosis: Preliminary Report. Biomed Res Int 2019; 2019:6078469.
- Shen J. Fully Endoscopic Lumbar Laminectomy and Transforaminal Lumbar Interbody Fusion Under Local Anesthesia with Conscious Sedation: A Case Series. World Neurosurg 2019; 127:e745–e750.
- Shen J, Telfeian AE, Shaaya E, Oyelese A, Fridley J, Gokaslan ZL. Full endoscopic cervical spine surgery. J Spine Surg 2020; 6:383–390.
- Shen J, Telfeian AE. Fully Endoscopic 360° Decompression Surgery for Thoracic Spinal Stenosis: Technical Note and Report of 8 Cases. Pain Physician 2020; 23:E659–E663.
- Gibson RDS, Wagner R, Gibson JNA. Full endoscopic surgery for thoracic pathology: an assessment of supportive evidence. EFORT Open Rev 2021; 6:50–60.
- Carr DA, Abecassis IJ, Hofstetter CP. Full endoscopic unilateral laminotomy for bilateral decompression of the cervical spine: surgical technique and early experience. J Spine Surg 2020; 6:447–456.
