How biportal endoscopic spine surgery is changing the present and future of outpatient spine care

Don Park, MD, professor of orthopedic surgery and director of minimally invasive spine surgery at UCI Health, joins Physician Huddle to discuss the evolution of endoscopic spine surgery and the development of the UCI Health outpatient spine surgery program at the UCI Health — Irvine medical campus.

Park explains how endoscopic techniques allow surgeons to treat common spine conditions through millimeter-sized incisions, using high-resolution cameras and specialized instruments. He describes how these approaches may support faster recovery, reduced pain, and a transition of appropriate spine procedures from the inpatient setting to an ambulatory surgery center.

The conversation also explores why the adoption of minimally invasive and endoscopic spine surgery has been gradual in the United States, the importance of hands-on training and mentorship, and how the UCI Health multidisciplinary spine program brings together orthopedic surgery and neurosurgery in a collaborative environment.

Park also discusses his use of an augmented reality headset during endoscopic lumbar fusion, the role of emerging technologies in the operating room, and the future potential of AI as an adjunct to surgical decision-making, visualization, and safety.

Topics discussed:

• Endoscopic spine surgery uses small incisions and high-resolution visualization to treat selected spine conditions, including lumbar disc herniations and lumbar stenosis.
• UCI Health is developing an endoscopic and outpatient spine surgery program that aligns with the Irvine medical campus and its ambulatory surgery capabilities. 
• Not every patient is a candidate for endoscopic surgery; Park emphasizes matching the right patient, pathology, and surgical approach. 
• Training is central to broader adoption because many surgeons did not learn endoscopic spine techniques during residency or fellowship. 
• Park views new technology through a patient-safety lens: It must make surgery better, more efficient or safer. 
• Augmented reality technologies may offer enhanced visualization and improved ergonomics during selected endoscopic spine procedures.
• AI’s future role in spine surgery may be as an adjunct that supports surgeons, rather than a replacement for clinical judgment.

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