Interlaminar endoscopic contralateral decompression: redefining technique through standardized maneuvers and nomenclature

Lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) is a minimally invasive procedure designed to treat lumbar spinal stenosis. While traditional uniportal endoscopic decompression already reduces tissue damage and promotes faster recovery compared to open surgery, this work introduces standardized terminology and specific endoscope-camera maneuvers to improve visualization and precision during both ipsilateral and contralateral decompression. By describing endoscope ("shaft") and camera head ("optic") rotations in a degree-degree format (e.g., 0-0, 90-0, 135-135, 180-180), the technique allows reproducible, targeted access to key anatomical areas while minimizing unnecessary bone removal. This systematic approach addresses the steep learning curve and technical intricacies of lumbar endoscopy, aiding intraoperative communication and potentially decreasing complications from inadequate decompression or poor visualization. The method aims to improve training, safety, and consistency of outcomes in endoscopic lumbar decompression procedures stenosis.