ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Tubular endoscopic spine surgery (TESS) for lumbar laminotomy: a technical feasibility study of a hybrid approach.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePercutaneous endoscopic spine surgery and tubular minimally invasive surgery (MIS) each offer distinct advantages but also important limitations. We describe a proof-of-concept study of a hybrid technique-tubular endoscopic spine surgery (TESS)-combining a tubular retractor with a 30° endoscope and continuous irrigation, aiming to integrate the advantages of both approaches.
methodsTESS was first evaluated in a cadaveric L4-L5 model and subsequently applied in a single clinical case of L4-L5 lumbar stenosis with right L5 radiculopathy. The technique uses a standard tubular retractor to establish a single paramedian muscle-splitting corridor. A 30° endoscope is introduced through the tube with continuous irrigation, while standard microsurgical instruments are used through the working channel.
resultsThe tubular retractor provided a stable, reproducible single-incision transmuscular corridor to the interlaminar space. The addition of the endoscope with irrigation ensured a consistently clear operative field, while maintaining the ergonomics and simplicity of a single working channel. Instrument handling and exchange were straightforward, and no specific technical difficulties were encountered. In the clinical case, adequate decompression was achieved with complete symptom resolution at 6 and 12 months.
conclusionTESS is a feasible hybrid technique that combines the familiar ergonomics of tubular MIS surgery with the dynamic visualization of endoscopic systems using irrigation. Further studies are needed to evaluate its clinical value before widespread clinical adoption.
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