Spinal surgery: Biportal endoscopic surgery heralds a new era for the H.U.B

The Brussels University Hospital (H.U.B) is the first hospital in Belgium to have acquired technology dedicated to biportal endoscopic surgery. An acquisition that further strengthens the expertise built up over a number of years ​ by the Department of Neurology in the field of minimally invasive spinal surgery, establishing the H.U.B as a pioneering hospital in Belgium. ​

Two access routes to regain the technical freedom of conventional surgery

Endoscopic surgery involves introducing a camera into the treatment zone for a precise visualisation of the anatomical structures while at the same time operating through a limited surgical opening. In the case of a monoportal approach the camera and surgical instruments enter through the same access route. While this method already permits certain interventions through a very small incision, it can limit the technical possibilities available to the surgeon. The biportal approach uses two small and distinct access ​ routes. One is for the camera and visualisation, the other is for the surgical instruments. ​ This configuration gives the surgeon greater freedom of movement and permits the use of instruments similar to those used in conventional spinal surgery, while retaining the advantages of the endoscopic approach. ​

“For the surgeon, the approach is particularly intuitive. We can operate on precisely those structures that are sometimes very deep or with difficult access without having to make a big opening to reach the treatment zone,” explains Dr Alphone Lubansu, Neurosurgeon and Director of the Spine Clinic at the Erasmus Hospital

A technique used across many indications

The development of biportal endoscopic surgery at the H.U.B covers a growing number of indications, notably: ​ ​ ​ discal hernias, lumbar spinal stenosis, stabilisation surgery and arthrodeses, the draining of certain infections and vertebral biopsies. ​ It will ultimately be possible to use the endoscopic approach ​ for more complex spinal fusion procedures as is already happening in some expert centres in Asia and the United States

“Endoscopy is probably one of the most important developments we have seen in minimally invasive spinal surgery. The biportal approach today allows us to envisage increasingly complex interventions through very limited access routes. It is a technological development that will progressively enlarge our surgical arsenal as well as our care offer,” stresses Professor Olivier de Witte, Director of the H.U.B Department of Neurosurgery.

More rapid recovery for patients

One of the benefits sought with endoscopy is to reduce the muscle and tissue trauma associated with surgery. ​ Less severe post-operative effects, earlier mobilisation and a shorter period of hospitalisation (reduced from 3 days to 1.5 days) can result. In the future, day hospitalisation can be envisaged. This development is also important in terms of the care pathway logic: ​ the aim is to enable the patient to ​ ​ regain their autonomy more rapidly and return more quickly to their family, professional or sports environment and at no extra cost. Thanks to the acquisition of this new technology, the H.U.B intends to continue to develop its neurological expertise and contribute to the expansion of endoscopic spinal surgery in Belgium. Its ambition is to become a reference centre for treating patients using this innovative approach and the associated training and development. ​