Minimally invasive Foot & Ankle Surgery

Updated 1/16/2014
The most common procedures would be bunion or hammer toe surgery. Ankle ligament and Achilles tendon repair surgeries are also frequently done in the outpatient setting. Achilles tendon repair procedures generally take about 40 minutes and patients are able to go home not long afterwards.
Dr. Bob Baravarian, University Foot and Ankle Institute

Babak Baravarian, DPM, is director of University Foot and Ankle Institute and foot and ankle surgeon with Saint John's Health Center in Santa Monica, Calif. Here, he answers questions about foot and ankle surgery and platelet rich plasma injections in the ambulatory surgery center setting.

 

Question: How often does your practice perform procedures in the ASC setting?

 

Dr. Bob Baravarian: We perform 95 percent of our procedures in an ambulatory surgery center setting. The only procedures we perform in a hospital are major reconstructive surgeries or procedures in patients with restrictive co-morbidities, such as obesity.

 

Q: What are a few of the most common foot and ankle procedures performed in ASCs?

 

BB: The most common procedures would be bunion or hammer toe surgery. Ankle ligament and Achilles tendon repair surgeries are also frequently done in the outpatient setting. Achilles tendon repair procedures generally take about 40 minutes and patients are able to go home not long afterwards.

 

Q: What kind of equipment do foot and ankle surgeons need to perform these cases in an ASC?

 

BB: Almost every large orthopedic company makes some sort of system that allows surgeons to cut bone and insert pins and screws. We used the Stryker Total Performance System. The goal of a system such as this is to be all-inclusive.

 

We use the same equipment used in knee arthroscopy, but with a smaller camera. A lot of our equipment has cross over with hand surgery. The knee and hips surgeons will tend to use different equipment. The tools for hand and foot surgery are more delicate.

 

We use a Mini C-arm, which involves less radiation than its larger counterpart. In addition, a Mini C-arm can be handled by the surgeon without the additional help of a surgical tech.

 

You, of course, need a supply of screws, plates and anchors. We use two of three vendors and usually have the supplies brought in case by case, so the ASCs do not need to buy in bulk, or we purchase items on consignment.

 

Q: What are the benefits of bringing these procedures to an ASC?

 

BB: Performing there procedures in an outpatient setting is beneficial from a time, cost consciousness and patient satisfaction standpoint. The majority of our procedures are done under nerve-block anesthesia. Patients are numb for 24 to 48 hours after the procedure. Patients are able to go home and become comfortable before beginning their postoperative pain control.

 

As we see continued change in healthcare and greater patient awareness of hospital costs, I think we will see the use of ASCs for ankle, foot and other orthopedic procedures augmented. Physicians are seeing that pain control can be better managed when patients are at home. ASCs have lower infection rates than hospitals and patients want to return home rather than staying in the hospital.

 

Q: What role do PRP injections play in foot and ankle surgery?

 

BB: We have done more than 5,000 PRP injections in our practice. These injections mainly play a role in the regeneration of soft tissue. After three to six months, the human body will decrease the inflammatory healing process. In patients with a chronic injury, one of the best options is to increase blood supply to the area. We have had very positive results with PRP injections.

 

In the ASC setting, we have used PRP injections to augment a lot of our soft tissue procedures, such as ligament repair. We are also using these injections to promote bone healing. In the surgical setting, we have seen the injections lead to quicker recovery times.

 

19,479 Total 1st Party Reviews / 4.9 out of 5 Stars
  • Google
    I looked at all the reviews before going to see Dr. Jafary and can say that it was and still is a great experience. He is a ver...
    Cheryl D.
  • GatherUp
    Great service and care. Highly recommend Dr. Franson.
    David B.
  • Yelp
    My son had a recent surgery there and I cant say enough about the level of professionalism and client service.  The Doctor (Dr....
    Laura K.
  • GatherUp
    If you have to go see a Doctor than this is a great experience.
    Frank M.
  • GatherUp
    My doctor was great. Really great
    Rudolph B.
  • GatherUp
    Good.
    David E.
  • GatherUp
    Your Santa Barbara office and Dr. Johnson always give me excellent care!
    Jayne A.
  • GatherUp
    Dr. Gina Nalbadian was amazing!! I came in with an emergency foot situation and she had wonderful bedside manner and resolved m...
    Danielle C.
  • GatherUp
    I was frustrated that after 3 weeks I still hadn’t heard back about my PT referral status. And I did sit in a room for over 30 ...
    Sarah C.
  • Yelp
    So far so good- Friendly staff that listens to my concerns. Great Doctor, and all around a good experience. Worth the travel in...
    Tony P.
  • GatherUp
    I’m very pleased with Dr. Kelman.
    Alan S.
  • GatherUp
    I had a wonderful experience with Dr Kelman and his staff. He outfitted me with excellent orthotics (which he’ll re-do at no co...
    Carolyn M.
Same Day Appointments
Now Available!

Or call 877-989-9110

24 hours a day, 7 days a week