Surgical systems including visualization assemblies with integrated irrigation and instrument guides

A method for performing a multi-portal spinal procedure on a patient, the method comprising:

• inserting an endoscopic visualization assembly into a first port on the patient to access a working space in the patient, wherein the endoscopic visualization assembly includes:
• a visualization instrument configured to endoscopically visualize the working space in the patient,
• a first visualization sheath configured to receive the visualization instrument, and
• a second visualization sheath configured to receive the visualization instrument and the first visualization sheath;
• inserting an irrigation cannula assembly into a second port on the patient spaced apart from the first port to access the working space, wherein the irrigation cannula assembly includes a cannula;
• inserting a first surgical instrument through the first port and along an instrument guide of the second visualization sheath;
• inserting a second surgical instrument through the second port and along the cannula of the irrigation cannula assembly;
• and
• visualizing, via the visualization instrument of the endoscopic visualization assembly, the working space.

An endoscopic visualization assembly for use during a spinal procedure on a patient, the endoscopic visualization assembly comprising:

• a first visualization sheath having a first channel;
• a second visualization sheath having a second channel and an instrument guide, wherein the second channel is sized to receive at least a portion of the first visualization sheath therethrough, and wherein the instrument guide is configured to guide a surgical instrument toward a working space in the patient;
• and
• a visualization instrument sized to at least partially extend through the first channel of the first visualization sheath and configured to visualize the working space.