Minimally invasive techniques have expanded across all disciplines of surgery because of some obvious and well-known advantages. These include less complications due to nerve injury, less scar tissue and stiffness, less vascular disruption, and much more aesthetically pleasing scars. The reduction in scar tissue, and vascular disruption also leads to a faster recovery with less post op pain, swelling, disability, muscle atrophy, and restriction in joint motion.
Foot surgery in general always leads to reduced patient mobility which disrupts physical activity, patient income for jobs requiring manual labor, and of course this can lead to disruptions in cardiovascular health as well. By minimizing recovery time and keeping patients active we can also improve general health outcomes.
Minimally invasive surgery for bunions, hammertoes, and other lumps and bumps enables patients to return to activity and work quickly and is thus very appealing to patients. The benefits listed above are very appealing to prospective patients and can remove some of the commonly held fears surrounding surgical bunion procedures. This is a huge selling point for most patients because maintenance of lifestyle is a huge motivating factor for when and if surgery is an option for most patients.
Many minimally invasive surgeons operate in small procedure rooms in their office. Many only use local anesthesia very much modeled after in-office dental procedures. This can add some tremendous benefit to your practice because you can do procedures much more quickly and avoid trips to and from a surgery center or hospital. Many patients dread the rigamarole of hospital checklists, long pre-op time, extended OR times, and long PACU recovery times to let the systemic medications wear off. Many patients have experienced simple in office dental procedures and its quite easy to understand that foot surgery can operate in almost the exact same way.
At the very least, if you learn some of the simple techniques that minimally invasive foot surgeons can teach you, you have tools to add to your arsenal. These tools can complement your traditional techniques and perhaps in time can replace some of them as you grow in confidence. A simple way to start is to try hammertoe procedures and cheilectomies. Both are simple techniques to learn with arguably superior outcomes when compared to traditional surgery. As an example, I think most surgeons would agree that hammertoe procedures performed in the traditional open approach are tedious, difficult, lead to stiffness, scarring, and unpredictable outcomes. I now enjoy performing hammertoe procedures because they are highly successful, quick, aesthetically pleasing, and much less traumatic to patients. Because they are so simple and atraumatic, follow up procedures are also simple, quick, and easy to perform in the office setting.
The surgical profession has evolved to embrace minimally invasive techniques because of well know and obvious advantages. Podiatry is well suited to make a transition to simpler, less invasive, in office procedures because we are highly experienced at performing nail avulsions and other simple procedures in the office. Learning new ways to do things can only improve your surgical skills. Ideally, I would recommend learning some simple minimally invasive techniques from experienced hands that can help you along the way. The AMIFAS conferences are a fantastic way to dip your toes into the water of MIS with highly skilled surgeons and hands-on cadaver labs that allow you to take home techniques to immediately integrate into your practice.