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To Michael: Endoscopic vs. invasive surgery

Posted by Trish on 8/24/99 at 00:00 (010160)

I'm interested to hear what you found out. I've had PF for 7 yrs.and in year 4 I had the traditional surgery performed by an orthopedic surgeon in Edmonton. It was a total failure and I also have sustained some nerve damage. 3 yrs. ago I flew to Toronto to see Dr. Hartley Miltchin because I had done some research and found out he was trained in the endoscopic method by Dr. Barret in Texas who apparently patented it. At that time, I decided against the surgery but have the same question as you......is there more chance of success with endoscopic surgery than the traditional method. Also, I am at a loss to know who are the real experts on PF, a podiatrist such as Miltchin or an orthopedic surgeon. I went to the 'best' ortho. surgeon in Edmonton, who does surgery on all the athletes at U. of A. and my experience with him was nothing short of HORRIFIC!!! Anyone out there have any feedback???

Re: To Michael: Endoscopic vs. invasive surgery

michael on 8/25/99 at 00:00 (010173)

Thanks for your message, Trish. I really haven't found out anything so far. This is the second time I've posted this question and I've yet to hear from anyone who's gone through both the invasive and the endoscopic surgeries. I beginning to wonder if ANYONE has...When I went to see Dr. Miltchin several years ago he seemed very confident that he could reduce or eliminate my foot pain.He claimed that during the first few days of recovery after invasive surgery the fascia does not re-attach itself properly because the foot is at rest, while after the endoscopic surgery the foot can be used right away and the fascia will therefore set itself in a much better position. However I am a diabetic (I am very well controlled and my pf is certainly not caused by any diabetic complications) and he would not operate on a diabetic in his clinic.
The orthopedic surgeon who performed my second invasive operation was Dr. Ted English at Scarborough General. A busy but good guy. I'm sorry you had a horrible time with your surgeon. I have to say that although he had no more success than my first surgeon, I think Dr. English did what he could and is very competent. Also he was kind of reluctant to perform the surgery in the first place, warning me that it well might not work - and I respect him for that. I spoke to him briefly once about endoscopic surgery, which he does not perform (I don't know if any orthopedic surgeons in Canada do) and he doubted that it was a better method. I think in general the success rate of surgery on pf is just not high enough for him to consider it a very smart course of action.
In May this year I saw Dr. Sheldon Nadal in Toronto, who also does the endoscopic operation. As I said previously, he and the doctors in San Fransico who trained him and who he consulted contradicted Dr. Miltchin and felt that endoscopic surgery didn't really offer a better chance of success. They felt it was a better procedure because it is not invasive, but that's about it. I think Dr. Nadal also wondered how well he'd be able to see and work in my foot with the scar tissue that's there from two previous operations. He was willing to try (and had no problems with me being a diabetic) but honest with his doubts.
I may yet try the endoscopic procedure, though I'd love to get an answer to my question first! I'll NEVER try the invasive method again - I think it's a pretty painful and ultimately useless procedure.And I didn't sustain any nerve damage - I can only imagine how you feel.

Re: To Michael: Endoscopic vs. invasive surgery

Trish on 8/25/99 at 00:00 (010182)

Miltchin told me the same thing......that he figured my first surgery didn't work because when you lay there for a week or so, not weight bearing, the fascia reattaches in the same position it was before....or something like that. thanks for your response. if you do get an answer to your question, please let me know. My email is (email removed)

Re: To Michael: Endoscopic vs. invasive surgery

John on 8/26/99 at 00:00 (010211)

maybe that is why i am in a half cast for 3 weeks to allow fascia to reattach in stretched position.

Re: To Michael: Endoscopic vs. invasive surgery

michael on 8/25/99 at 00:00 (010173)

Thanks for your message, Trish. I really haven't found out anything so far. This is the second time I've posted this question and I've yet to hear from anyone who's gone through both the invasive and the endoscopic surgeries. I beginning to wonder if ANYONE has...When I went to see Dr. Miltchin several years ago he seemed very confident that he could reduce or eliminate my foot pain.He claimed that during the first few days of recovery after invasive surgery the fascia does not re-attach itself properly because the foot is at rest, while after the endoscopic surgery the foot can be used right away and the fascia will therefore set itself in a much better position. However I am a diabetic (I am very well controlled and my pf is certainly not caused by any diabetic complications) and he would not operate on a diabetic in his clinic.
The orthopedic surgeon who performed my second invasive operation was Dr. Ted English at Scarborough General. A busy but good guy. I'm sorry you had a horrible time with your surgeon. I have to say that although he had no more success than my first surgeon, I think Dr. English did what he could and is very competent. Also he was kind of reluctant to perform the surgery in the first place, warning me that it well might not work - and I respect him for that. I spoke to him briefly once about endoscopic surgery, which he does not perform (I don't know if any orthopedic surgeons in Canada do) and he doubted that it was a better method. I think in general the success rate of surgery on pf is just not high enough for him to consider it a very smart course of action.
In May this year I saw Dr. Sheldon Nadal in Toronto, who also does the endoscopic operation. As I said previously, he and the doctors in San Fransico who trained him and who he consulted contradicted Dr. Miltchin and felt that endoscopic surgery didn't really offer a better chance of success. They felt it was a better procedure because it is not invasive, but that's about it. I think Dr. Nadal also wondered how well he'd be able to see and work in my foot with the scar tissue that's there from two previous operations. He was willing to try (and had no problems with me being a diabetic) but honest with his doubts.
I may yet try the endoscopic procedure, though I'd love to get an answer to my question first! I'll NEVER try the invasive method again - I think it's a pretty painful and ultimately useless procedure.And I didn't sustain any nerve damage - I can only imagine how you feel.

Re: To Michael: Endoscopic vs. invasive surgery

Trish on 8/25/99 at 00:00 (010182)

Miltchin told me the same thing......that he figured my first surgery didn't work because when you lay there for a week or so, not weight bearing, the fascia reattaches in the same position it was before....or something like that. thanks for your response. if you do get an answer to your question, please let me know. My email is (email removed)

Re: To Michael: Endoscopic vs. invasive surgery

John on 8/26/99 at 00:00 (010211)

maybe that is why i am in a half cast for 3 weeks to allow fascia to reattach in stretched position.