Is laser surgery for bunions possible?
From time to time, patients ask if our minimally invasive bunion surgery is performed with a laser.
I often wonder how this could happen, and then I jump to why the patient would want a laser bunion removal. To my knowledge (updated 2017) there is no doctor that performs bunion surgery with a laser.
Lasers are used during some foot procedures such as wart and fungus removal, but I have not been made aware of any doctor cutting foot bones with a laser to remove a bunion. I have been on the receiving side of laser eye surgery, which has worked out pretty well – so who knows if laser bunion removal will ever come to be – I never say never….well, I guess I should say that I very infrequently say never, but none exist that I know of.
Then, I think, why would anyone want, or request laser bunion surgery.
There certainly would be advantages of laser bunion surgery – as the intensity of a cutting laser typically results in less bleeding because when a cut is made with a laser, it also coagulates small blood vessels at the same time. This is not the best for bunion surgery because a bleeding bone is necessary for healing to start.
Also, the laser would have to be such that it is powerful, intense enough to cut bone, but not cut things like skin, tendons, which is tough to control.
Also, the cosmetic result may be better as well.
Make a small hole, shift the bunion over, maybe no stitches would be needed and there wouldn’t even be a scar.
Have you ever seen the scar from someone who has had bunion surgery: perhaps a sibling, mother, grandmother, uncle?
A lot of times there is a huge scar on the top of the foot where the bunion used to be or is – if it came back! I have had plenty of patients come in for a second opinion after having surgery by another doctor and say: “I wish I had my bunion back.”
They often have a huge scar, or line across their foot that is raised and red, and most times they have had a couple of surgeries with multiple long scars, sometimes pins coming out of their toe, or several plates and screws.
So, I guess that trying some form of laser bunion surgery would appeal to many people if it was possible.
I will say that at Northwest Surgery Center, we do the closest thing to laser bunion surgery. Our incisions are very small, and only a single stitch is needed to close the incision.
Also, the way that we fix the bunion, we use special, minimally invasive surgical instruments that make very small cuts in bone, tendons and ligaments that are likely smaller than any cut a laser would make. Maybe the next time a patient asks if we do laser bunion removal, instead of saying: “no, that is not possible”, I will say, “not yet, but we offer something even better!”
We are able to make very small cuts in the skin, bones, tendons and ligaments that I bet the scars are so minimal that they would not be much different if a laser was used.
Almost every foot doctor learns how to do open surgery or long incisions. This is a traditional way, and you can see the bone, bone cuts, screws, plates and wires.
We are taught, that it doesn’t matter how long the incision is, it doesn’t heal lengthwise, but rather it heals side to side. Well, I would partially disagree with this.
The multiple layers of skin and soft tissue and bone can create large scars not just on top of the skin that you can see, but also beneath it. This can lead to decreased motion or movement of the toe(s).
Also, the longer the cut, there might be a greater chance of cutting something such as nerves, which would lead to pain or numbness, or blood vessels that can lead to a lot of bleeding and swelling. So, if there is a way to do laser bunion surgery, I will be one of the first to learn how to do it.