Laparoscopic lumbar discectomy: description of transperitoneal and retroperitoneal techniques

Dissatisfaction with minimally invasive lumbar discectomy via the postero-lateral route led the authors to develop the laparoscopic lumbar discectomy technique. The technique has evolved to a retroperitoneal route that is easier and safer than the tranperitoneal one. The ideal treatment for lumbar disc herniation is accessing the epidural space directly for selective removal of the disc herniation rather than indirectly treating it via a transdiscal route. The authors describe a method of accessing the epidural space directly through the foramen using a combined discographic and retroperitoneal approach.