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Foot and Ankle Unit

Spire Bushey Hospital, North London

Minimally invasive forefoot surgery

  • Mr Rod Coull has established a foot and ankle service in Hertfordshire that delivers multidisciplinary management of all foot and ankle problems and now offers minimally invasive forefoot surgery.

    This type of surgery is suitable for patients who require correction of hallux valgus (bunions) and hallux rigidus (painful stiff toe) and other lesser toe conditions.

    The minimally invasive method allows the surgeon to perform the surgery laparoscopically (keyhole). This procedure reduces soft tissue injury and scarring and allows correction of the deformity with minimal surgical intervention.

    This minimal invasive foot surgery is based on traditional foot surgery treatment techniques and offers numerous patient benefits including:-

    • Promoting faster recovery following surgery
    • Allowing faster return to sports, social and professional activities
    • No unsightly scarring of the foot (no stitches required)
    • No need for wires protruding from the foot post-operatively.

    Why change from traditional ‘open’ forefoot surgery?

    Traditionally forefoot surgery requires a 4-8 cm incision over the inner part of the foot with a small 1 cm incision between the first and second toe. Soft tissues are lifted from the bones which are then cut and the deformity corrected.

    The minimally invasive method allows the surgeon to perform the bony division in a closed, keyhole type manner, preserving the soft tissue attachments which promotes healing.

    This technique has been developed by a small number of foot and ankle surgeons who have a large experience with open forefoot surgery.

    This new technique has allowed us to perform traditional operations but in a less invasive manner, which means that patients can have the predictable recovery that is associated with open forefoot surgery but with much less damage to the skin & soft tissues.

    How is minimally invasive forefoot surgery performed?

    The surgeon makes several 3 mm incisions through which to perform the correction using a 2 mm diameter cutting device to shave or cut the bone in a controlled manner under x-ray guidance.

    Where shaving excess bone from the foot is required, the surgeon carefully removes this unwanted bone. If a correction is needed the correct position is attained and a screw is placed in the bone to maintain this position until the bone heals. These screws are small and designed to sit inside the bone reducing their need for removal.

    It is important that minimally invasive forefoot surgery is carried out by a specialist foot and ankle surgeon with extensive experience of open forefoot surgery, which forms the fundamentals of this technique.

    Suitability for minimally invasive forefoot surgery

    After having a specialist consultation and assessment, Mr Coull can advise whether minimally invasive forefoot surgery is appropriate. Typically, patients with mild to moderate deformities are suitable for this type of ‘keyhole’ surgery.

    Mr Coull provides expert advice on all aspects of foot & ankle surgery and his aim is to ensure that the treatment he provides leads to the best possible outcome for his patients.

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