Endoscopic spine surgery comes with some hurdles such as the learning curve. But a greater barrier facing spine surgeons wanting to add endoscopic technology is the implementation itself, Kai-Uwe Lewandrowski, MD, said.
Dr. Lewandrowski discussed this challenge and how surgeons can tackle it in an upcoming episode of the “Becker’s Spine and Orthopedic Podcast.”
Note: This is an edited excerpt.
Question: Clinically speaking would you say endoscopic decompression is mature enough to scale?
Dr. Kai-Uwe Lewandrowski: Absolutely. We spent the last 10 to 12 years developing clinical evidence on the application of the endoscopic minimally invasive decompression in an outpatient setting. We worked up the patient selection criteria, we published clinical protocols. Come to find out, thinking that was the most significant hurdle in terms of insurance authorization, but it actually wasn’t performing the endoscopic surgery. We’ve done some survey work that revealed that the main hurdle is actually logistical and implementation.
Q: Can you dive deeper into that? This idea that the barrier is implementation and what can surgeons do to address that?
KL: We developed some content to help surgeons with the discussions locally in the surgery center. But what it comes down to is that the cost for the capital equipment is high. The endoscopes have high maintenance costs. They don’t last that long. They last on average, 35 to 50 surgeries, then they’re essentially broken. So, when you look at all the hidden costs, which include sterilization, reprocessing, cleaning, they sound like trivial issues, but for surgery centers, they can turn into real problems where they just don’t have the staffing to process these scopes on time, so that this ASC can make money in a hospital setting. You may be competing with other service lines that are racking up costs. So, integrating the endoscopic technique platform is not as trivial, and we’ve learned that from multiple service studies that we’ve done nationally and internationally.
