[Impact of surgeon's dominant hand-side consistency with surgical approach on operational efficiency of unilateral biportal endoscopic lumbar discectomy: a prospective cohort study].

Objective: To investigate the impact of the surgeon's dominant hand-side on the operational efficiency and safety of primary lumbar discectomy under unilateral biportal endoscopy (UBE). Methods: A prospective cohort study was conducted in 60 patients with single-level lumbar disc herniation who underwent UBE lumbar discectomy between August 2024 and August 2025 by the same right-handed surgeon, including 30 patients with non-dominant (right approach) (non-matched group) and 30 patients with dominant (left approach) (matched group). No significant difference was observed between the two groups in baseline data including gender, age, body mass index, herniated segment distribution, disease duration, and preoperative visual analogue scale (VAS) score and Oswestry disability index (ODI) ( Results: There was no significant difference in the total operation time and intraoperative blood loss between the two groups ( Conclusion: Consistency between the surgeon's dominant hand side and the surgical approach side significantly improves core endoscopic operational efficiency and surgical fluency in UBE lumbar discectomy, without compromising clinical efficacy or safety. It is suggested that this matching factor should be prioritized in surgical scheduling and beginner training to optimize the operative experience and shorten the learning curve.