Minimally Invasive Foot Surgery
A surgical approach built around less disruption and faster recovery — smaller incisions, reduced soft tissue trauma, and most patients walking the same day. Bunion correction, hammertoe repair, and more.
Andrew Gunter, DPM — San Antonio, TX.
Call (210) 581-9800
A Different Approach to Foot Surgery
For many patients, the word 'surgery' carries a specific set of assumptions: a large incision, significant postoperative pain, weeks of restricted activity, and a long road back to normal footwear and daily life. Those assumptions are largely based on experience with traditional open foot surgery — and they have led many patients to put off procedures that could meaningfully improve their quality of life.
Minimally invasive foot surgery challenges those assumptions at every point.
MIS techniques use small percutaneous incisions — typically a few millimeters — rather than the larger incisions required for open procedures. Specialized instruments allow Dr. Gunter to perform precise bone corrections and soft tissue work through these small access points with significantly less disruption to surrounding structures. The results: reduced visible scarring, less postoperative discomfort, and a faster return to weight bearing and normal activity for most patients.
Dr. Andrew Gunter has trained in minimally invasive techniques specifically to offer his patients options that align with their lives — not just their diagnosis. The most commonly requested MIS procedures at this practice are bunion correction and hammertoe repair, both of which are well-suited to minimally invasive approaches in appropriate candidates. MIS techniques are also applied to other foot conditions where the approach offers meaningful advantages over traditional open surgery.
Every surgical decision begins with a thorough in-office evaluation. Not every condition and not every patient is a candidate for a minimally invasive approach — and Dr. Gunter will give you an honest assessment of your options, the tradeoffs, and his recommendation based on your specific anatomy and goals.
A SUMMARY:
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Small percutaneous incisions — typically a few millimeters
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Less soft tissue disruption than open surgery
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Greatly reduced visible scarring
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Most patients walking the same day
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Performed under local anesthesia with sedation or general anesthesia
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Outpatient — no overnight hospital stay
MIS PROCEDURES PERFORMED BY DR. GUNTER:
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Bunion correction (hallux valgus)
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Bunionette correction
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Lapidus bunionectomy
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Hammertoe repair
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Metatarsal osteotomies
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Plantar fasciotomy
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Gastrocnemius recession / Achilles lengthening
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Other foot conditions — ask at consultation
Minimally invasive surgery vs. Traditional open surgery
Both approaches have their place — the right choice depends on your specific condition, severity, and anatomy. Dr. Gunter performs both and will recommend the approach best suited to your individual situation.
Incision size
Minimally Invasive
Small percutaneous — typically a few millimeters
Traditional Open Surgery
Larger incision for direct joint visualization and correction
Visible scarring
Minimal
More visible scarring along incision line(s)
Same-day weight bearing
Most patients walk same day in post-op shoe
Varies — often restricted or no weight bearing initially
Anesthesia
Local with sedation or general — patient preference
Local with sedation or general
Setting
Outpatient — no overnight stay
Outpatient for most procedures
Best suited for
Appropriate candidates — evaluated individually
Moderate to severe deformities; complex cases
Soft tissue disruption
Minimal — targeted access only
More extensive — broader exposure required
Minimally Invasive Procedures for Bunions & Hammertoes
Bunion correction and hammertoe repair are the most frequently requested minimally invasive foot surgery procedures at this practice. Both conditions are well-suited to MIS approaches in appropriate candidates and represent meaningful quality-of-life improvements for patients who have been avoiding traditional surgical options.
Minimally Invasive Bunion Correction
A bunion — hallux valgus — is a progressive structural deformity at the base of the big toe. In appropriate candidates, MIS bunion correction repositions the metatarsal bone and corrects the toe alignment through small percutaneous incisions rather than a large open approach. The result is the same structural correction with less visible scarring, less postoperative discomfort, and a faster return to normal footwear for most patients. Dr. Gunter evaluates every bunion on weight-bearing X-ray before recommending a surgical approach.
Minimally Invasive Hammertoe Repair
A hammertoe is a progressive bending deformity of one or more smaller toes at the middle joint. In appropriate candidates, MIS hammertoe correction addresses the deformity through small incisions that minimize soft tissue disruption and reduce the risk of postoperative swelling and stiffness. The procedure straightens the affected toe and alleviates the pain and footwear difficulty the deformity causes. Most patients are walking the same day in a post-op shoe.
Minimally Invasive Bunionette Correction
A bunionette — the bony prominence at the base of the little toe on the outer edge of the foot — can be corrected using the same minimally invasive percutaneous approach as bunion correction. Small incisions allow Dr. Gunter to reposition the fifth metatarsal and remove the excess prominence with minimal soft tissue disruption, reduced visible scarring, and a faster return to normal footwear for most patients.
Learn more about bunionettes →
Endoscopic Plantar Fasciotomy
For patients with chronic plantar fasciitis that has not responded to comprehensive conservative treatment, endoscopic plantar fasciotomy offers a minimally invasive surgical option. Using two small portal incisions and endoscopic visualization, Dr. Gunter releases a portion of the plantar fascia to reduce chronic tension and allow healing — with significantly less soft tissue disruption and a faster recovery than open surgical release.
Dr. Gunter applies minimally invasive techniques to other foot conditions where the approach offers meaningful advantages. Ask at your consultation whether your specific condition is a candidate for a minimally invasive approach.
What to expect before, during, and after MIS surgery
The consultation
Before any surgical discussion, Dr. Gunter performs a thorough evaluation — clinical examination, weight-bearing X-rays, and a complete assessment of your deformity, foot structure, and overall health. He will explain your condition clearly, present the full range of treatment options, and give you an honest recommendation. There is no pressure — the decision to proceed with surgery is always yours. Dr. Gunter believes it's his job is to help you reduce pain and discomfort and achieve the activity level you'd like, not to sell you surgery.
Anesthesia
Minimally invasive foot procedures can be performed under local anesthesia with sedation or under general anesthesia. Dr. Gunter's preference is to defer this decision to the patient and the anesthesiologist together, based on your health history, anxiety level, and the specific procedure being performed. Both approaches are safe and appropriate. You will discuss this at your pre-operative appointment.
The procedure
Most MIS foot procedures are performed on an outpatient basis — you go home the same day. The procedures are usually performed at CHRISTUS Santa Rosa Alamo Heights or its neighboring ambulatory surgical center, both of which are modern, fully equipped outpatient facilities. The surgical time varies by procedure and complexity.
After surgery
Most patients having MIS bunion or hammertoe procedures are walking the same day in a post-operative protective shoe. This is one of the most meaningful advantages of the minimally invasive approach for patients whose daily lives cannot accommodate extended restricted weight bearing. Recovery details, activity restrictions, and follow-up scheduling are discussed at your pre-operative appointment. Every patient's recovery is individual.
Why Patients Choose Dr. Gunter
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Frequently Asked Questions — Minimally Invasive Foot Surgery
Ready to find out if minimally invasive surgery is right for you?
The first step is a consultation — a thorough evaluation of your condition, an honest conversation about your options, and a recommendation built entirely around your anatomy and your life. Dr. Andrew Gunter, DPM — serving San Antonio and surrounding communities from CHRISTUS Santa Rosa Alamo Heights and affiliated facilities.
Call (210) 581-9800