Weighing The Pros And Cons Of Minimally Invasive Surgery

Big surgeons make big incisions. This is the mantra I learned and have always lived by.

I do incision planning, full anatomic exposure and direct visualization of the surgical site. This has been great from a surgical perspective but from a postoperative perspective, big incisions can lead to residual swelling, tissue scarring and adhesions. 

As surgical professionals explore minimal incision surgery with laparoscopic surgery, robotics, endovascular techniques and bone surgery, it brings up the question: Is minimally invasive surgery for the foot all that bad?

Some tout the benefits of minimally invasive surgery, including faster healing times, decreased pain, increased range of motion and faster return to activity. But what about the concern for surgical accuracy?

Although there is less tissue handling and management, there is also less precision. The meticulous approach to good anatomic dissection becomes less of a concern through a less invasive approach. Surgeons can do bone cutting with narrow blades and burrs, and insert hardware percutaneously under fluoroscopic guidance.

Postoperative radiographs of minimally invasive bunion and bone osteotomy surgery make me question the outcome and make me nervous sweating out the healing process.

On the other hand, as the patient feedback comes in and more research focuses on positive foot and ankle Visual Analogue Scale scores, my interest is piqued.