Minimally invasive surgical procedures are increasingly used. Minimally invasive (percutaneous) surgical procedures have also become established in the field of foot surgery. While the basic principles correspond to those of conventional surgery, the minimally invasive foot surgeries are only carried out via small percutaneous incisions of a few mm. The smaller surgical approaches can reduce the risk of wound healing disorders and infections. Furthermore, the scars are barely visible from a cosmetic point of view in minimally invasive surgical procedures.
In contrast to minimally invasive techniques at other locations, the minimally invasive surgical procedures on the foot are not yet widespread. These techniques have been developed and advanced, particularly in Spain. For some years now, the minimally invasive techniques of foot surgery have been increasingly used in other countries (Germany, UK) and have been part of the training concepts of the German foot societies.
How the procedure is done?
The surgical technique allows correction of several foot deformeties or pathologies at the same time. Although the operation is only performed through stab incisions, the procedure must be done in a hospital under complete sterile conditions in the OR. Whether the surgery is performed as an outpatient or inpatient procedure, depends on the extent of the pathology to be corrected. In most cases, regional anesthesia of the foot is sufficient. Bone can be removed through the incisions using special drill devices. With the same devices corrections of the bone axis can be performed (osteotomies). This is done under X-ray control in the operating theatre. For most of the corrections, the insertion of metal implants (wire, screw, plate) is not necessary. Accordingly, there is no need for a second procedure to remove the implants. However, larger corrections may also require the insertion of screws or wires with the minimally invasive surgical technique.
The small stab incisions of the skin must not hide the fact that the basic principle here are the same as that of open procedures. This manifests itself in the fact that the foot tends to swell even after minimally invasive surgery. Although this tends to be less pronounced than with open techniques, it is nevertheless observed. However, due to the percutaneus approach, risks like wound healing disturbances and infections can be reduced compared to open procedures.
Correct aftercare is an essential part of the minimally invasive surgical procedure. A special redressing bandage is placed in the operating room to keep the foot and toes in the corrected position. In addition, a special shoe is adapted. Full weight bearing is immediately allowed in this shoe. Depending on individual needs, walking supports can be used for a few days. The first change of dressing takes place after a week. The stitches are removed and a special splint is put on to hold the foot and toes in the correct position. In total, this splint usually must be worn day and night for a total of 6 weeks after the operation. For a further 6 weeks, the splint should then only be worn at night. Full load on the foot is allowed and desired during all this time.
Hip replacement is one of the most successful surgeries in orthopedic surgery and highly standardized. In addition to the choice of suitable implants, the surgical aproach is of crucial importance for the outcome of the procedure.
You can find all information about hip replacement here.