The Basics and Concepts of Unilateral Biportal Endoscopy

Unilateral biportal endoscopy (UBE) is endoscope-assisted spinal surgery, which requires making a series of “working space.” The authors introduce the meaning of “working space” and the steps for acquiring an atraumatic working corridor and space. UBE is fluid-medium surgery, not air-based. Continuous and controlled circulation of the saline is the critical factor in performing successful UBE surgery. The optimal hydrostatic pressure and factors related to fluid-related complications are described. The authors would like to introduce the operation setting and surgical tools of UBE. Then, eight basic concepts of UBE would be described. Trials to understand and utilize the basic concepts should be ongoing. By doing so, a consistently desirable surgical outcome is guaranteed while minimizing the possibility of complications.