Medicine in general and surgery in particular are evolving towards more and more advanced techniques. Open techniques in traumatology and orthopedic surgery are the surgeon’s main weapon, but it is from his previous knowledge that the surgeon manages to develop arthroscopic and endoscopic techniques, which are more desirable when they are possible.
Minimally invasive techniques maintain the precision of open techniques, since they provide direct vision of the area to be operated on by means of an optical system, preserving the integrity of all the tissues that are damaged by open access. The accesses are made through incisions of between 0.5 and 1 cm known as “portals”. Their benefits are unquestionable, although they require a high degree of training, dexterity and precision.
When and in which cases are minimally invasive techniques used?
By studying each case carefully and verifying that there is a correct indication, this type of techniques can be used for:
- Knee, hip, shoulder or ankle arthroscopies.
- Disc herniation
- Problems such as cuff tears or shoulder instabilities.
- Meniscal or anterior cruciate ligament tears in the knee,
- anterior or posterior ankle and hip impingement
- Sprain and fracture sequelae
- Arthrosis or articular cartilage injuries in the ankle, knee or hip.
The ankle is one of the joints in which arthroscopy and endoscopy is in full development, both accessing the anterior chamber (arthroscopy) and the posterior area (endoscopy).
In addition, in a novel way in Spain, endoscopy is being performed in the spine to treat sciatica and herniated discs.
Minimally invasive spine surgery
The latest minimally invasive techniques in the spine, especially transforaminal endoscopy, are performed in Spain only by the team led by Dr. Casal Grau. This technological advance offers better results than traditional endoscopy. Transforaminal Lumbar Percutaneous Percutaneous Discectomy is performed with a single endoscopic access in the spine, through the holes of conjunction to the herniated discs. This allows to solve different sciatica or stenosis conditions with minimal aggression, without altering the bone structure of the spine. Patients are able to walk within a few hours and are discharged from the hospital the same day of the operation or the following day at the latest.
Tenoscopy
Tenoscopy is the percutaneous access to the tendon sheaths to explore and sometimes treat them without causing any damage or sequelae as in open surgery. This is of particular interest to athletes.