Minimally Invasive Surgery

What is Minimally Invasive Surgery?

Minimally invasive surgical procedures are commonly used to investigate, diagnose and treat orthopaedic disorders that fail to respond to physiotherapy, medication or other non-surgical treatments.

The term Minimally Invasive Surgery is often shortened to the abbreviation M.I.S and can also be referred to as 'Arthroscopic' or 'Keyhole Surgery".

This procedure represents a distinct technological advance in the way an orthopaedic surgeon can choose to operate on a patient, as it provides a quick, easy and clear view of the inside of a joint or space through a pencil slim, high-resolution camera, known as an Arthroscope, without the need to fully open a joint with a traditional incision (cut).

The main advantage of MIS is that less trauma is caused to the skin, underlying tissue and muscle as the surgical incisions needed in this type of surgery are only small 'Key Holes' rather than a lengthy surgical cut. The speed of a patient's recovery following MIS surgery is therefore remarkably shorter and considerably more pain free than when compared to other traditional surgical methods.

There are two types of MIS or Arthroscopic Surgery performed although it is most common for these procedures to be provided at the same time:

i. Diagnostic: (investigation to find out what is wrong with a joint)

ii. Therapeutic: (correction of an injury or fault within the joint).

Which orthopaedic procedures can be performed using an M.I.S technique?

Minimally Invasive Surgery is usually performed in order to investigate and treat persistent pain, swelling, clicking, catching, dislocation and instability of a joint caused by either age related wear and tear, arthritis or trauma.

The most commonly performed MIS procedures are as follows:

(Please click on any of these procedure titles to see more specific detail about how a procedure is performed).

• Arthroscopic Spinal Surgery
• Ankle Arthroscopy
• Carpal Tunnel Syndrome (wrist)
• Frozen Shoulder
• Glenoid Labrum Tear (shoulder)
• Hip Arthroscopy
• Hip Replacement
• Hip Resurfacing
• Knee Arthroscopy
• Knee Replacement
• Rotator Cuff Repair (shoulder)
• Shoulder Arthroscopy
• Shoulder Dislocation
• Shoulder Impingement
• Wrist Arthroscopy

How is M.I.S carried out?

M.I.S can be performed under General Anaesthetic (you will be asleep) or Regional Anaesthetic (you will be awake). The procedure usually takes only a short amount of time to perform if the injury or condition is of a minor nature (approximately 30 minutes), although repair of a more complex nature can take much longer. The vast majority of M.I.S procedures are provided on a Day-Case basis.

During an M.I.S procedure two small incisions (cuts) just a few millimetres in length are made either side of the problematic joint. These two incisions allow a narrow tube with a camera within it to be inserted into one and a slim tube that will regularly inject fluid and rinse the inside of the joint into the other. The injected fluid will allow the surgeon to get a good view of the problem area via the camera lens as he moves it around the inside of the joint or space.

Once the problem is properly identified, another small incision can then be made elsewhere (sometimes two incisions are made) in order to insert exceptionally fine instruments into the problematic joint or space. With the aid of clear vision via the camera, the surgeon can then guide his fine instruments and gently correct the problem without any need to fully open up the treated area.

Common corrective procedures performed during an M.I.S procedure are:

• Drainage of inflamed joint fluid
• Removal of torn or loose fragments of cartilage
• Removal of loose fragments of bone or irregularities caused by arthritis
• Reconstruction or repair of a fibrosed capsule, torn cartilage or a torn ligament 
• Some carefully selected joint replacement or resurfacing procedures

At the end of the procedure the small keyhole wounds on the joint are usually closed with a single stitch and a simple dressing.

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid complications such as joint stiffness and Deep Vein Thrombosis from developing. It is therefore normal for patients to be encouraged to undertake physiotherapy exercises and walk a gentle distance just a few hours after surgery.

Following a progressive improvement of mobility and pain control, patients are normally discharged home 4-6 hours after their surgery for most MIS procedures except joint replacement or resurfacing procedures. By the time the required level of recovery is achieved for discharge, patients are normally wearing only a simple wound dressing over their 'keyhole' incisions, eating and drinking normally and taking only mild analgesia (pain killers) to control any pain.

Over the next 6 weeks patients will be expected to work on improving their own mobility and range of joint movement through dedicated and progressive physiotherapy and by increasing their daily activity levels. Your Consultant Surgeon will then assess your condition and range of movement after 1 week and then again after three months to evaluate how successful the M.I.S procedure has been.

Individuals in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take up to 6 months to achieve.

Are there any risks associated with MIS surgery?

Although M.I.S surgery is very regularly performed without any complications, it is very important that all candidates are fully aware of both the benefits and risks of undertaking such specialist surgery, especially in relation to the surgeon occasionally needing to abandon this technique in favour of a traditional incision method in a problematic case.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation to discuss your condition with an expert in M.I.S in relation to these risks cannot be over emphasised.

How do I find out if I am a suitable candidate for M.I.S?

Surgical Advisor will be delighted to help you find a leading expert in M.I S surgery to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Orthopaedic Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating specialist orthopaedic surgery and because of their M.I.S expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that patients are comfortable with any recommendations or advice given in their consultation, all patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an expert orthopaedic surgeon in M.I.S techniques: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com