Minimally invasive surgery

We would like to respond to the most common questions that our patients ask about MIS.

1. What is MIS?

Minimally invasive foot surgery is a surgical method that permits us to correct many foot pathologies using small incisions without direct exposure to the surgical planes. This results in minimal injury to the soft tissue. Fluoroscopy is utilized during the procedure to orient the surgeon in the procedures being performed.

2. Where is minimally invasive foot surgery performed?

Minimally invasive foot surgery is performed in a hospital or certified and accredited surgical facility. Even though MIS is less invasive and traumatic than traditional procedures, we still follow the same preventative measures as if major surgery was being considered.

3. What type of anesthesia is utilized?

Local anesthetic. In almost all minimally invasive procedures we utilize local anesthetic (from the ankle down). This reduces significantly possible complications associated with anesthetics.

4. What is the typical postoperative course?

This surgery is absolutely ambulatory. As soon as the surgery is completed, the patient in a special surgical shoe or boot is allowed to walk or ambulate that very moment. The patient is asked to return anywhere from three to seven days after the surgery for a dressing change, removal of any sutures if used, and a new bandage is applied that the patient is instructed to change as often as indicated for an average of two to three weeks.

5. When can a patient return to work and exercise?

Normal activities that do not require impact or abnormal stress or long periods of time standing on the foot, a patient can do many activities starting the very first day. However, a surgical postoperative shoe may be required. Sport activities can be initiated in approximately two to three weeks, however jumping or impact activities usually require two months waiting period.

6. Can I have both of my feet operated on at the same time?

Both feet can be operated on at the same time. However, there may be more restrictions placed on activities allowed. It is usually recommended if you are to return to work promptly (days) that one foot be operated on at a time.

7. Is it true that bunions return after MIS surgery?

These MIS surgical procedures like traditional are designed for permanent correction. However, studies have shown that a recurrence rate in MIS surgery is less than 5%. The medical literature demonstrates good and excellent results in 90% or better.

8. Is laser used in MIS surgery?

It is absolutely false that minimally invasive surgery can be performed with laser. These procedures are performed through very small incisions using the latest and modern technologies resulting in excellent postoperative results. Lasers are reserved for soft tissue lesions such as warts, etc.

9. Can all bunions and hammertoes be corrected using MIS?

As in traditional surgery, there are some conditions that are contraindicated. Only an expert in minimally invasive surgery can decide what procedure is indicated. The vast majority of foot pathology can be corrected using MIS.

10. Are pins and screws used in MIS surgery?

In general, pins and screws are not used in MIS surgery.
Minimally invasive procedures as described damage less soft tissue structures and are inherently more stable, and for optimal results do not require fixation with screws, pins or plates. However, there are conditions in which a surgeon may decide that these fixation devices are necessary, for example arthrodesis (fusion) procedures, etc.

11. What are possible complications?

In all surgery, both traditional and minimally invasive, there can be complications, in general, like problems with anesthetic, allergies, etc. and others locally such as infections, recurrence of the deformity, delayed healing, long term inflammation, etc…
As doctors, we work hard and fight to reduce and minimize these problems and work to solve these problems when presented, we cannot guarantee that in 100% of the cases we will have good results.