Keyhole Spine Surgery/ Endoscopic Spine Surgery Endoscopic Spine Surgery, also known as Keyhole Spine surgery is a most recent and advanced surgical technique for disc herniation. its done in two ways - Interlaminar approach and Transforaminal approach. Interlaminar approach is done under general anaesthesia. A small half an inch cut is made in the back to remove the disc. this approach can also be used for lumbar canal stenosis but only in selected cases. Transforaminal approach is done under local anaesthesia with slight sedation. Patient is conscious throughout the surgery and can tell about leg pain if the surgeon is working near the nerve therefore increasing the safety of surgery. However, the surgery may last fro 30 minutes to 2 hours and patient has to be cooperative and not move during the surgery without telling surgeon. Beauty of transforaminal approach is that patient is walking 30 mins after surgery. But this approach is indicated for only disc herniations without much migration and is not suitable for stenosis.