Endoscopic Foot Surgery

Most patients having any type of surgery prefer to have a procedure that’s as minimally invasive as possible.

This is also true with any type of surgery involving various parts of a foot and/or ankle. Fortunately, a growing number of foot-related procedures can now be performed with less invasive endoscopic techniques.

Here’s a closer look at what’s involved with endoscopic foot surgery and why it may be recommended or performed.


Reasons for Endoscopic Foot Surgery

It’s increasingly common for endoscopic procedures to be used to remove excessive scar tissue or redundant cartilage from a joint in the foot, a procedure referred to as arthritic joint debridement. Heel spurs may also be removed with this form of endoscopic surgery. Another reason for endoscopic foot surgery is to correct damage to ligaments affected by a severe foot or ankle sprain. The same endoscopic techniques may be used to correct issues with damaged articular cartilage around the “big toe” joint.

Patients with chronic plantar fasciitis may benefit from an endoscopic plantar fasciotomy (EPF). It’s performed to release part of the plantar fascia ligament to ease tension and reduce inflammation. Success rates for this procedure are above 80 percent based on results that have been reported in various studies.

Endoscopic foot surgery may also be performed to:

  • Diagnose and treat chronic and post-traumatic ankle pain
  • Complete flat foot reconstruction surgery
  • Diagnose and treat foot pain related to damage from arthritis
  • Complete minimally invasive bunion or hammertoe surgery
  • Address issues related to Morton’s neuroma
  • Evaluate a fractured foot that’s not healing well to determine if surgical correction is necessary

Prior to recommending endoscopic foot surgery, the affected foot or ankle is typically examined thoroughly to determine if a less invasive approach to surgery is the right option. This process usually includes CT scans, X-rays, or other types of image tests. Generally, patients are advised to stop eating solid foods about 12 hours before endoscopic surgery. It’s also important for patients to disclose all medications they are taking, especially NSAIDs (non-steroidal anti-inflammatory drugs) and similar drugs that may increase bleeding risks.

Most foot endoscopies, including ones done for both diagnostic and treatment purposes, are outpatient procedures. The specific approach to endoscopic foot surgery will depend on what part of the foot is being operated on and what needs to be done.

However, the general approach to this type of surgery involves small incisions instead of larger ones. A special flexible tube with a light and lens attached to it, called an endoscope, is inserted into one of the small incisions made in the affected foot.

The surgeon will be able to view the affected area in greater detail with the scope. Special instruments are then used to perform the intended procedure on the affected part of the foot or ankle. After surgery is completed, the small incisions may be closed with stitches or a special type of glue (“liquid stitches”). Most endoscopic procedures are done with a sedative. However, general anesthesia may be used for more extensive foot surgery or for younger patients. Patients tend to enjoy the following benefits from endoscopic foot surgery:

  • Shorter surgical time
  • Reduced risk of unintended damage to nearby foot tissues or nerves
  • Faster healing and minimal post-surgery scarring
  • Reduced risk of infection
  • Lower risk of blood loss
  • Less post-op discomfort
  • Shorter recovery time
  • Less time missed from school or work

With most endoscopic foot procedures, there will be a need to keep pressure off of the affected foot for a certain period of time to allow tissues and/or foot bones or joints to heal. This may be accomplished with the use of crutches or a cam boot.

Medication is sometimes prescribed if there is lingering discomfort during the healing/recovery period. Physical therapy that typically includes therapeutic exercises and stretches may be recommended to help strengthen muscles, tendons, and ligaments in the foot that was operated on. During a follow-up visit, X-rays may be done to make sure the affected foot is healing properly.

While there are many possible benefits associated with endoscopic foot surgery, it’s not right for every foot problem. A specialist at a foot and ankle center can determine if you may benefit from a minimally invasive technique. Even if a less invasive type of operation ends up not being the best option for your situation, an endoscopy may still be performed for diagnostic purposes to get a better idea of what’s going on with specific bones, joints, or soft tissues in your foot.

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