PELD (Percutaneous Endoscopic Lumbar Discectomy)

A detailed medical history of the patient will be asked for and every minute detail will be recorded by the doctor. Besides, if the patient is on any medication currently the same should be informed, and allergic reaction or side effects to a particular medication should also be mentioned clearly. Further, if the patient is consuming any dietary supplements or consumes tobacco and alcohol, it should be informed before the procedure.

A list of tests shall be carried out such as:

• Blood
• Urinary
• Metabolic
• Pregnancy
• Pulmonary
• Cardiovascular
• Medications (To check the level of existing medication in the patient’s body)

Besides, following shall be asked to consider before the procedure:

• The possibility of blood loss is there in this procedure.
• Stop smoking or use of any tobacco.
• Consent of the patient will be required for this procedure. Please read the form carefully before signing and ensure to ask every minute question that comes to mind.

Further, make sure to arrange proper transportation, keep a reliable person who can stand besides the patient throughout the procedure to assist carefully whenever required, arrange all sorts of groceries for at least ten days, listen vigilantly and strictly adhere to the instruction of the physician.

• PELD is conducted in about one hour and is performed using local anaesthesia that results in mild sedation. This surgery is an endoscopic day care procedure.
• The surgery is done on a radiolucent table, where the patient is made to lie down flat with the chest area facing down and back up.
• A small incision of about 8-10 centimetres is made from the midline.
• The midline considered for the incision is on the posterior part of the body.
• Now, the process of removing the inter-vertebral disc material is carried out.
• An external imager termed as the fluoroscope, is used to direct the probe. The probe is then used to deliver the laser energy that assists in vaporizing a part of the inter-vertebral disc. This further decompresses the nerve root.
• After the procedure, a sanitized dressing is done on the surgical area.

• Usually after this procedure, patients are fit enough to be discharged home on the same day of the surgery. However, in some cases, the patient might be required to stay overnight for rest or observation at the hospital.
• The recovery process of the patient after this surgery takes place quickly, and he/she is usually allowed to perform the daily activities within three to four weeks post procedure.
• Physical therapy might be required, especially if the patient is old. Care of back is to be taken for many months till healing is complete.

Following are the complications that might happen after a PELD:

• Inadequate decompression (This shall lead to a second operation, which will involve a different technique)
• Injury due to the thermal effect of the laser
• Nerve damage (Due to improper placement)