Endoscopic Percutaneous Discectomy is a minimally invasive spine surgery performed under local anesthesia with sedation. The procedure begins with the surgeon making a small incision, typically less than 1 cm, near the affected disc. A needle is inserted through this incision, guided by fluoroscopic imaging to ensure accurate placement. The surgeon then introduces a series of dilators to create a working channel to the disc.

An endoscope—a thin tube with a camera and light source—is inserted through this channel, providing real-time visualization of the disc and surrounding structures. Using specialized instruments passed through the endoscope, the surgeon carefully removes the herniated disc material pressing on the nerve root. Throughout the procedure, the surgeon can monitor progress on a video screen. Once sufficient disc material is removed to decompress the nerve, the instruments are withdrawn, and the small incision is closed with a stitch or surgical tape.

Endoscopic Percutaneous Discectomy offers numerous benefits compared to traditional open spine surgery. The procedure's minimally invasive nature results in significantly smaller incisions, typically less than 1 cm, leading to reduced tissue damage and scarring. This approach minimizes blood loss during surgery and lowers the risk of infection. Patients often experience less post-operative pain, resulting in decreased need for pain medication and a lower risk of opioid dependence.

The procedure is usually performed on an outpatient basis, allowing for shorter hospital stays and quicker returns to daily activities. Recovery times are generally faster, with many patients able to resume work and light activities within weeks rather than months.

While generally considered safe, Endoscopic Percutaneous Discectomy carries some risks. These include infection, bleeding, and nerve root damage, though less common than in open surgery. There's a possibility of incomplete disc removal, potentially requiring further intervention. Rare complications can include dural tears, leading to cerebrospinal fluid leakage. Some patients may experience temporary numbness or weakness. The procedure may not relieve all symptoms, especially in complex cases. There's also a small risk of recurrent disc herniation. As with any spine surgery, there's a minimal risk of paralysis or other severe neurological complications. Individual factors can influence specific risks, necessitating thorough discussion with a surgeon.

To prepare for Endoscopic Percutaneous Discectomy, follow your surgeon's specific instructions. You'll need to undergo pre-operative tests, including imaging and blood work, and disclose all medications and supplements you're taking. Stop taking blood-thinning medications as directed and fast (no eating or drinking) before the procedure. Arrange for someone to drive you home post-surgery and prepare your home for recovery, ensuring essentials are within easy reach. It's important to stop smoking, as it can impede healing. Discuss any concerns or questions with your surgical team. Follow instructions about showering and skin preparation, and wear comfortable, loose clothing on the day of the procedure.

After Endoscopic Percutaneous Discectomy, patients typically go home the same day. Rest is crucial, but short walks are encouraged to promote circulation. Pain management may involve over-the-counter or prescribed medications. Apply ice to reduce swelling. Keep the incision site clean and dry, following specific wound care instructions. Avoid bending, lifting, or twisting for a few weeks. Gradually increase activity levels as advised by your doctor. Attend follow-up appointments and complete any prescribed physical therapy. Most patients can return to light work within 1-2 weeks, with full recovery in 4-6 weeks. Contact your healthcare provider immediately if you experience fever, increased pain, numbness, or drainage from the incision site.