2.2.2. Interlaminar endoscopic discectomy (ILED).
With more central protrusions that are harder to reach or more voluminous sequesters, especially at the L5/S1 level, the interlaminar approach was used. The working channel with the endoscope was introduced in the midline, very similar to a microdiscectomy. To enter the spinal canal, only a small part of the ligamentum flavum needs to be removed. The dural sac is then moved medially with a special maneuver to enable working in the central part of the channel.