Minimally invasive foot surgery

The minimally invasive foot surgery , also MIS ( m inimally i ncision s urgery called), is a specialized field of minimally invasive surgery and includes all surgical procedures on the foot, which are carried out on millimeter-sized entrances with specially designed instruments (cutters). To simplify matters, the term "keyhole surgery of the foot" is also used here because of the very small skin openings.

history

The beginnings of technology go back to the 1960s. During this time podiatrists tried to remove disturbing bone structures ( exostoses ) percutaneously, i.e. H. to be removed through small openings in the skin. Some time later, even simple osteotomies were successfully performed. Unfortunately, inadequate instruments were used for the innovative surgical method - cutters and turbines from the field of dentistry. These machines generated the necessary torque only at a high speed, which led to burns of the bones and skin, and thus to infections and wound healing disorders. It was not until the 1990s that Stephen A. Isham dared to carry out a forefoot correction with suitable instruments and published excellent results. After extensive anatomical examinations, Mariano de Prado published a comprehensive work in 2003 with all the operative approaches and tips for safe and effective implementation of minimally invasive interventions. David Redfern and Joel Vernois then published the first studies that substantiate the effectiveness of the technology.

meaning

For years, the goal of surgical therapy has been to accelerate recovery after surgery. It was also evident that this could be achieved by reducing iatrogenic damage, among other things . The first successful attempts in the field of laparoscopy and thoracoscopy were carried out by Hans Christian Jacobaeus . The first minimally invasive joint operations ( arthroscopies ) were carried out by Severin Nordentoft from Denmark around 1912 and Kenji Takagi from Japan, who published the first intra-articular color photos in his work “The Arthroscope” in 1938.

Keyhole techniques are an integral part of modern surgery today.

With the MIS technology it is possible to efficiently protect the skin, tendons and joints, since the surgeon can work through small skin incisions with specially developed instruments. The modern milling cutters offer a high torque at a low speed, so that the risk of thermal damage is very low. The MIS is a special keyhole technology in which the surgeon has no direct view of the operating field, so that he can only orient himself with the help of an X-ray device and his tactile sensation. In order to meet this challenge, an exemplary anatomical education as well as regular training is necessary.

literature

↑ M. Polokoff: Raspostectomy. Reduction of exostoses and hypertrophied condyles with files and rasps . In: Journal of the American Podiatry Association . tape 52 , August 1962, ISSN 0003-0538 , p. 599-602 , PMID 14487677 ( nih.gov [accessed July 5, 2020]).
^ DR Levitsky: Percutaneous osteoclasp fixation of akin osteotomy: an alternative fixation technique . In: The Journal of Foot Surgery . tape 20 , no. 3 , 1981, ISSN 0449-2544 , pp. 163-166 , PMID 7276456 ( nih.gov [accessed July 5, 2020]).
^ SA Isham: The Reverdin-Isham procedure for the correction of hallux abducto valgus. A distal metatarsal osteotomy procedure . In: Clinics in Podiatric Medicine and Surgery . tape 8 , no. 1 , January 1991, ISSN 0891-8422 , p. 81-94 , PMID 2015537 ( nih.gov [accessed July 5, 2020]).
^ De Prado M, Ripoll PL, Golano´ P .: Cirugıa percutanea del pie. Tecnicasquirurgicas. Indicaciones. Bases anatomicas . Ed .: Masson. Barcelona 2003.
↑ David Redfern, Joel Vernois, Barbara Piclet Legré: Percutaneous Surgery of the Forefoot . In: Clinics in Podiatric Medicine and Surgery . tape 32 , no. 3 , July 2015, ISSN 1558-2302 , p. 291-332 , doi : 10.1016 / j.cpm.2015.03.007 , PMID 26117570 ( nih.gov [accessed July 5, 2020]).
↑ S. Nordentoft: About Endoscopy closed cavities using my trocar-endoscope . In: Verh Dtsch Ges Chir . 1912, p. 78-81 .

[1] M. Polokoff: Raspostectomy. Reduction of exostoses and hypertrophied condyles with files and rasps . In: Journal of the American Podiatry Association . tape 52 , August 1962, ISSN 0003-0538 , p. 599-602 , PMID 14487677 ( nih.gov [accessed July 5, 2020]).

[2] DR Levitsky: Percutaneous osteoclasp fixation of akin osteotomy: an alternative fixation technique . In: The Journal of Foot Surgery . tape 20 , no. 3 , 1981, ISSN 0449-2544 , pp. 163-166 , PMID 7276456 ( nih.gov [accessed July 5, 2020]).

[3] SA Isham: The Reverdin-Isham procedure for the correction of hallux abducto valgus. A distal metatarsal osteotomy procedure . In: Clinics in Podiatric Medicine and Surgery . tape 8 , no. 1 , January 1991, ISSN 0891-8422 , p. 81-94 , PMID 2015537 ( nih.gov [accessed July 5, 2020]).

[4] De Prado M, Ripoll PL, Golano´ P .: Cirugıa percutanea del pie. Tecnicasquirurgicas. Indicaciones. Bases anatomicas . Ed .: Masson. Barcelona 2003.

[5] David Redfern, Joel Vernois, Barbara Piclet Legré: Percutaneous Surgery of the Forefoot . In: Clinics in Podiatric Medicine and Surgery . tape 32 , no. 3 , July 2015, ISSN 1558-2302 , p. 291-332 , doi : 10.1016 / j.cpm.2015.03.007 , PMID 26117570 ( nih.gov [accessed July 5, 2020]).

[6] S. Nordentoft: About Endoscopy closed cavities using my trocar-endoscope . In: Verh Dtsch Ges Chir . 1912, p. 78-81 .