Life Empangeni Private Hospital leads the way

Revolutionary spinal surgery debuts at Life Empangeni Private Hospital

LIFE Empangeni Private Hospital recently played host to the second ever Unilateral Biportal Endoscopy (UBE) surgery to take place in South Africa.

Local neurosurgeon Dr Kritish Timakia and specialist orthopaedic surgeon Dr Sailesh Ragoo performed the surgery under the watchful eyes of world renowned UBE expert Prof Hayati Aygün.

Prof Aygün is a specialist in orthopaedics, traumatology and spinal surgeries, hailing from Turkey. Spanning a career of more than 30 years, Prof Aygün has performed more than 4000 UBE surgeries and regularly imparts his knowledge at international webinars and workshops.

He paid a special visit to South Africa last week to do the same, mentoring doctors Timakia and Ragoo, and the Life Empangeni Private Hospital theatre team, in performing the province’s first nine UBE cases.

The patients underwent the UBE procedure for various spinal conditions, and all have been discharged following a short hospital stay to monitor their health.

Bringing the technique to Zululand

Dr Timakia has been studying the technique of UBE since 2019. He has visited Austria to sharpen his skills and regards Prof Aygün as one of his mentors in this field.

He is very excited about the prospects of bringing UBE to South Africa and Zululand, in particular.

“The only available equipment in South Africa is at Life Empangeni Private Hospital. Now we need to bring it to the people.”

He said that Zululand has a vast footprint, with many patients suffering from painful and debilitating spinal conditions that need surgery. However, factors such as frailty, existing health conditions, old age, financial status and even fear prevent people from getting surgical intervention.

Back surgery is often a major, life changing procedure which involves many risks.

“UBE is an option for patients who are not fit for traditional surgery. UBE has the potential to help large numbers of people to manage their pain without the need for expensive treatment.”

Despite UBE’s many benefits, Dr Timakia does caution that it will never completely replace traditional ‘open’ spinal surgery. This is determined by each patient’s unique circumstances.

“Being equipped with the technology and skills to perform UBE does not change the manner in which we approach spinal intervention. Just because it seems easier, it does not mean we will rush the procedure. We still have the responsibility to treat our patients with the utmost care,” Dr Timakia said.

Benefits of UBE

Compared to traditional open surgery, it’s a minimally invasive surgical  technique with less trauma, reduced pain, and faster healing.

According to Prof Aygün, the benefits of UBE are tremendous.

“UBE surgery has minimal muscle damage, it provides better visualisation  for the surgeon, and through UBE almost all the target points become accessible.”

He explained that the UBE procedure has been used in neurosurgery since the 1990s, and has gradually become the preferred option to treat spine diseases in recent years.

“Especially after the introduction of newly advanced techniques, neck hernia surgeries can be performed with this method too. In cases of a herniated disk, endoscopic microsurgery can be used to extend the channels through which the nerves pass. A UBE will lead to less anatomical damage so this method should be prioritised.”

He added that UBE involves a lot less pain for the patient.

“With classical spinal surgery methods, in which the ribs are often cut, the patient will experience pain, regardless of how small the incision is. However, with the endoscopic method, two or four holes will be opened on the patient, which will heal much quicker post-operatively. It entails making a small incision.”

What is Unilateral Biportal Endoscopy (UBE)?

Endoscopic surgery can be used on various parts of the body, such as the spine, stomach or gall bladder. It entails the incision of a small opening in which a tiny camera is inserted. Using an advanced imaging system, the area is projected onto a large screen, enabling the physician to have a clear view of the area being operated.

By contrast, UBE involves two portals – one to insert the optical instrument, and one for surgical instruments. Surgical instruments are used directly through one working tube, and a visual field can be provided by the spinal endoscope in the other working tube.

Both working tubes can serve as either a viewing or working channel, allowing for more flexible visual fields and instrument manipulation during the procedure. UBE allows for wider surgical vision than one portal spine endoscopy.