Endoscopic Spine Surgery South Australia

What is ESS?

  • Endoscopic spine surgery (ESS) is an ultra-minimally invasive (keyhole) form of spine surgery, combining tiny incisions with high-definition endoscopic visualisation of spinal anatomy and pathology.
  • Encompasses discectomy, decompression/laminectomy and even spinal fusion.

Why consider ESS?

  • Less trauma to the muscles and soft tissue on approaching the pathology.
  • Less post-operative pain related to the procedure itself.
  • Quicker recovery and return to activities (such as driving and work).
  • Shorter hospital stay (day cases possible).
  • Reduced surgical risks (including dural tear/CSF leak, infection and bleeding).
  • Tiny incision (~8 mm).
  • Equally as effective as open surgery from a pain resolution perspective.
  • Recurrence rate of disc herniation is no worse than open surgery.
  • Can be done under local anaesthesia, making ESS an option for patients who would otherwise be deemed too high-risk for a general anaesthetic.

ESS Limitations:

  • Cannot replace traditional spine surgery in the setting of severe spinal deformity, mechanical instability and trauma.
  • Only performed by highly trained Spinal Surgeons (ESS is an evolving field of spine surgery).
  • Long term outcomes are still being determined.

How is ESS performed?

  • ESS requires specialised equipment (endoscopic spine stack and endoscope), which is presently only available at The Memorial Hospital.
  • Dr Tsimiklis uses the joimax® full endoscopic spine surgery system, which is state of the art and market-leading equipment.
  • Support through industry with distribution of joimax® equipment by LifeHealthcare.
  • Ongoing education and keeping up to date with research through the Endoscopic Spine Academy.

The Future of ESS

  • Growth of the ESS community in SA (training of other Orthopaedic Spinal Surgeons and Neurosurgeons with support by Dr Tsimiklis).
  • Further development in advanced ESS techniques including cervical and thoracic spine surgery.
  • Procurement of necessary equipment through SA Health so that public patients can also benefit from ESS both at the Royal Adelaide Hospital and Flinders Medical Centre.

Videos about ESS

ESS Links

  • ESPINEA: Endoscopic Spine Academy.
  • joimax®: The company that makes the endoscopic spine stack that Dr Tsimiklis uses.
  • LifeHealthcare: The company that distributes the joimax® stack to hospitals and has supported Dr Tsimiklis with his ESS education/training.


If you would like an opinion from Dr Tsimiklis regarding your spinal condition and suitability for endoscopic spine surgery, you may send a message via our enquiry form on the contact page or obtain a formal referral from your GP to see Dr Tsimiklis.