Biportal endoscopic spinal surgery or BESS is a less harmful spinal surgery that matches the technique of microscopic spinal surgery. According to the use of an arthroscopic for an endoscopic instrument, this surgery is also technically similar to endoscopic spinal surgery. This type of minimally invasive surgery has the benefits of reduced muscle injury, preserving stability, dissection, and risks of restabilization. The purpose of all those three above-mentioned surgeries is the same to reduce the risk factor. Some studies show that there are some limitations in conventional endoscopic spinal surgery and microscopic spinal surgery. These limitations are difficult to access the contralateral area and limited what space in the tubular retractor. But this new biportal endoscopic spinal surgery provides bilateral or unilateral decompression of lumbar Central spinal stenosis, low-grade spondylolisthesis, and foraminal stenosis.
As per the study, BESS decreases the rate of postoperative infection due to continuous irrigation through the procedure. It has also decreased the fusion surgeries for first or second-level limber stenosis. The clinical outcomes for the other processes have some limitations like complications after the surgery such as clearing of dural and postoperative epidural hematoma. But the all-new BESS has made things easier for the patients as well as surgeons
Ref: https://pubmed.ncbi.nlm.nih.gov/30959588/
