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Prairie Path Foot & Ankle Clinic

Minimally Invasive Surgery (MIS)


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9/27/2013
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With all of the ways in which our lives have become more efficient, faster paced and with everything accessible at the tips of your fingers, people's expectations have changed in all aspects of life.  What's very unfortunate about this is that some things in life cannot be made to produce immediate, easy results.  We are all anxiously looking for a "quick fix" and when it comes to the human body, this is not a realistic expectation. 

Not only do you have to work out and diet consistently and be patient to see results of your efforts for weight loss, but you cannot make your body heal on a convenient schedule.  There are ways to improve the healing process after surgery and to minimize risks.  However, be wary of promises advertised for having your bunion fixed over the lunch hour or any procedure that boasts quick results with minimal scar or healing time.

There was a movement in podiatry years ago for what was called MIS or minimally invasive surgery.  What this means is that surgeries would be performed with a very small incision that would heal more quickly.  While there are some acceptable variations of this out there, including arthroscopy of the ankle, it is important to exercise great caution when being wooed by these promises.  Even though this was more popular in the past, there are still many physicians that offer these services.

Bunions are one main example that people sought (and continue to seek) to have treated with this approach, but bunions are a complicated deformity.  It is not simply a bump that needs to be filed down.  If a complicated deformity is addressed through a small incision this does not allow adequate visualization of all the tissues around this bump.  When you can't see something (like a nerve, vein or artery), how can you avoid damaging it?  In medical school we learn the general and most common mappings of these delicate structures, but people are people.  We are all a little different and our anatomy is no exception. In addition to nerves/arteries/veins, we have a capsule around each our joints.  This capsule provides some of the blood flow to the bones in these areas.  To open the skin through a small incision, insert an instrument and burr this down, you violate this capsule and therefore some of the blood flow.  Because you can't see it, there is no hope of repairing this.

Imagine those ships that people make in bottles.  They do all that work through a small hole, but the reason that this works is because the bottle is clear!  Imagine how well those would turn out if the bottle was painted black and the artist could not see through it.  Our skin will never be that clear.

By attempting to correct a bunion through a small incision, the underlying cause of the bunion cannot be addressed.  Let's say that the surgery goes great, you don't end up with nerve damage or damage to blood vessels - the results will not be lasting because the underlying cause of the deformity has not been addressed.

Be mindful that many foot deformities do not develop over night and therefore they cannot be corrected over night.  When it comes to correcting deformities of the foot surgically, your body needs time to recover. Many bunion procedures require a cut in the bone to shift it to a more anatomical position.  This is, in essence, a controlled fracture of the bone.  Science has not come so far as to make people heal magically and quickly and without swelling.  Leave that to Harry Potter.  It's vital to have patience when facing surgery and the recovery afterwards. 

If you have questions about a deformity or problem in your feet, contact us at Prairie Path Foot & Ankle Clinic and we can talk seriously about your condition and what appropriate treatment options are available to you.

 



Category: Bumps and Bunions


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