Surgeon Performs Ultra Minimally Invasive, Single Portal Endoscopic Spine Surgery - First in Orange County

Hoag Orthopedic Institute (HOI) spine surgeon Richard Lee, M.D., has performed Orange County’s first next generation “ultra minimally invasive (MIS),” single-portal endoscopic spine surgery, a breakthrough technique done through a single incision less than one centimeter in size.

The ultra MIS uni-portal arthroscopic spine surgery system uses a spine-specific endoscope, equipped with a camera and light source, providing unparalleled visibility of the surgical site while ensuring the delicate spinal structures remain undisturbed.

“The primary benefits of a single portal endoscopic spine surgery are reduced tissue and muscle disruption, with the possibility of shorter recovery time and a faster return to daily life,” said Dr. Lee. “Each patient we treated with this surgical technique had a single incision about the length of a pencil’s eraser, making this a truly breakthrough advancement in the treatment of spinal issues.”

As one of the early adopters in Orange County of ultra MIS, Dr. Lee was the first to apply the next generation tissue sparing dissection technique to retrieve a large 32 millimeter extruded lumbar disc herniation as a single piece in a surgery to relieve pressure off of the spinal thecal sac at Hoag Orthopedic Institute. Current surgeries that can be performed using this technology include laminectomy, discectomy and neurotomy. According to the technology manufacturer, Arthrex, this is the biggest intact disc fragment resection done with their endoscopic ultra MIS platform anywhere in the country to date.

“This surgical approach may be appropriate for patients with disc herniations, severe stenosis and spine pathology who have exhausted other treatment options,” said Dr. Lee.

HOI partnered with Arthrex, a company known for its arthroscopic surgical tools, to perform these surgeries using a next generation less invasive prototype system allowing the procedures to be done through a smaller incision. Three procedures have been completed successfully in the past several months. All procedures were performed on an outpatient basis—none required a hospital stay—and all patients were mobile and able to move around immediately.

Traditional spinal surgery involves incisions to open the spinal column and perform necessary procedures. Previous endoscopic spine surgery involved making an incision for the camera and additional incisions for placement of surgical tools used to perform the spinal procedure. Today’s next-generation endoscopic equipment allows spine surgery to be performed through a single small incision and single portal, accommodating both the camera and surgical instruments.

HOI’s experienced team, including 27 orthopedic spine surgeons and neurosurgeons, perform the most spine surgeries in Orange County, ranging from minimally invasive, endoscopic and robotic surgeries to complex revision surgeries. HOI’s depth of expertise has helped us achieve excellent outcomes in the nearly 2,400 spine surgeries performed at our hospital and surgery centers last year.