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Keyhole-Endoscopic Surgery

Fully endoscopic spinal surgery also known as keyhole surgery is an advanced cutting-edge technology whereby spinal surgery is performed through an endoscope or a specialised camera optic system.


The concept of performing complex operations using keyhole technology is not new and ever then before it has been used in orthopaedic knee and shoulder surgery. Spinal keyhole surgery has evolved over the years and with advancement of technology it is possible to perform more complex surgery in a minimally invasive fashion. Keyhole approach is associated with lesser blood loss, tissue damage and early recovery/ rehabilitation. 

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Illustration of interlaminar approach 

Initially described in 1970’s, the approach was through the foramen or the tunnel (Read More) and was predominantly designed to answer disc herniation. However, in 1990’s the indication was expanded, and newer generation surgeons adopted interlaminar techniques. This adaptation made the approach more versatile and opened the door for “Fully Endoscopic Spinal Surgery”. Nowadays, 3rd and 4th generation surgeons can perform much complex procedures throughout the spine and are pushing the boundaries of minimally invasive spinal surgery.  

Why Endoscopic Spinal Surgery?


The evolution of spinal surgery over the last century has moved from operating with bare eyes to loupes (Eyeglasses) to microscope and tubes. The philosophy behind each stage of development was to minimise the tissue damage and to provide better visual field for the operating surgeon. The development of endoscopic spinal surgery represents another such a milestone towards further advancement and may become the gold standard in future. 


Spinal pathologies like Disc Herniation (Slipped disc/Disc bulge/ Sciatica) and Stenosis can be approached through a KEYHOLE. The novel technique minimises soft tissue destruction and reduces the post-operative blood loss and inflammation. This along with early mobilisation facilitates early recovery and rehabilitation for better post-operative outcome. 


Depending upon the pathology the procedure can be performed through 

  1. Interlaminar approach 

  2. Transforaminal approach

  3. Extraforaminal approach 


Details of the pathology and the approach will be discussed during the consultation prior to the surgery. 

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