Prospective Evaluation of a 3-Blade Speculum Cannula for Minimally Invasive Lumbar Microdiscectomy

Dr. Kingsley R. Chin of the Less Institute

Scientific Paper

Chin KR1Michener TA.

Interested medical professionals can read through the full paper, as published in Clinical Spine Surgery, here.


Minimally invasive spine technology is still in an evolutionary stage. This prospective study reports the technical feasibility, benefits, and limitations of using a 3-blade speculum cannula for minimally invasive lumbar microdiscectomies. We studied 52 consecutive patients, 24 males and 28 females, with a mean age of 36.1 years (range 20 to 68 years) and body mass index of 29.6 who underwent a microdiscectomy using this access device that opened to create a cylindrical working channel. We prospectively documented the length of the incision, estimated blood loss, length of surgery, outcomes using the visual analog scale for leg pain, and complications. The average incision length was 20.9 mm (range 13 to 30 mm). Average blood loss was less than 50 mL. Ninty-six percent of the patients had complete resolution of their radicular leg pain with improved mean visual analog scale scores from 8 to 0.3 postoperatively (P<0.5). Mean surgical time decreased with experience from 135 minutes for the first 15 patients, 103 minutes for the next 22, and 75.2 minutes for the last 15, to an overall mean of 108 minutes (range 51 to 188 minutes) and a 56% decrease for the last 38 patients. Body mass index did not affect surgical time or incision length. Seventy-five percent of the patients were discharged on the day of surgery and the remainder within 23 hours. Two symptomatic hematomas required reoperation using the retractor at 3 days and 4 weeks postoperatively. This new speculum minimal access device was effective for lumbar microdiscectomy in limiting the size of the incision without the need for sequential dilation, providing excellent visualization with the aid of a microscope, allowing same-day discharge after surgery, and demonstrating improved outcomes even in obese patients. This device may provide insights for the improvement of design considerations for other minimally invasive access devices.

About Author Orthopedic Surgeon Dr. Kingsley R. Chin

Dr. Kingsley R. Chin, founder of philosophy and practice of The LES Society and The LESS Institute
Dr. Kingsley R. Chin, Founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin is a board certified Harvard-trained orthopedic spine surgeon and professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Studies at the University of Technology, Jamaica.

Learn more about Dr. Chin here and connect via LinkedIn.

About Less Exposure Surgery

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit to learn more.

About SpineFrontier

The above study utilized Less Exposure Surgery by SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

Scientific Paper Author & Citation Details


Chin KR1Michener TA.

Author information

  1. Spine Surgery Service, Department of Orthopaedics, University of Pennsylvania, PA 19104, USA.

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