With advances in technology, the development of specialist equipment and enhanced surgical skills it has been possible to perform complex surgical procedures through small skin incisions.

The aim of minimally invasive surgery (MIS) is to:

• Do the least damage to normal healthy tissues and structures
• Enhance healing and thereby recovery times
• Achieve the same if not better result as one would by a traditional open technique

MIS techniques employ the use of small skin incisions and a “portal” through which to work through. Small burrs and specially designed instruments, under image guidance or arthroscopy are then used to carry out the procedure. Mr Malik also employs a number of procedures through minimally invasive incisions in addition to standard MIS to obtain excellent outcomes. For example the use of percutaneous and mini-open skin incisions.

For further details just ask your surgeon Mr Malik.

Advantages

• Speeds recovery
• Shorter duration of hospital stay
• Less trauma to the patient
• Less pain
• Less blood loss
• Smaller skin scars
• Less internal scarring
• Reduced post-operative complications
• Ability to operate on patients who may be unable to undergo open procedures ie due to poor skin quality, previous scars

Disadvantages

• Requires specialist and expensive equipment
• MIS should only be performed by surgeons who have undergone specialist training such as Mr Malik
• The operation time may take longer than a traditional open procedure
• It may be necessary to proceed to open surgery if during the MIS procedure it is felt that a better outcome will be achieved using an open technique

The same eligibility criteria exists for Minimally Invasive Surgery (MIS) as for any surgical procedure:

• Failure of conservative management
• Patient fitness for surgery
• Patient social circumstances (support at home)
• Condition amenable to surgery

Some patients will not be suitable for MIS. For example if severe pre-existing deformity exists it may not be possible to achieve a full correction (however whenever possible this will always be attempted in the first instance using MIS – discuss with your surgeon Mr Malik for further details).

Patients with very high Body Mass Index (BMI) are also less likely to be suitable for MIS.

The following is list of procedures (not exhaustive) performed using MIS:

Ankle joint surgery

• Removal of scar tissue
• Removal of loose bodies
• Removal of inflamed tissue (synovitis)
• Debridement of osteochondral lesion and microfracture
• Ankle fusion
• Anterior impingement
• Posterior impingement
• Removal of Os trigonum
• Aid in fracture reduction

Achilles tendon

• Achilles tendon acute repair
• Chronic Achilles tendon repair
• Tendon debridement
• Tendon reconstruction

Big toe arthritis

• Cheilectomy

Bunion surgery

•  Minimally invasive chevron osteotomy (MICA)

Lesser toe deformity correction

• Hammer toe deformity correction
• Claw toe deformity correction
• Mallet toe deformity correction

Subtalar joint surgery

• Debridement of osteochondral lesion and microfracture
• Subtalar joint fusion
• Aid in fracture reduction

Complications can occur with Minimally Invasive Surgery as with any type of surgery. Please see Complications for more detailed explanation of post surgical complications.

The main complications are:

• Risks and complications of anaesthesia
• Bleeding
• Infection
• Blood clots
• It may be necessary to proceed to open surgery if during the MIS procedure it is felt that a better outcome will be achieved using an open technique