Minimally invasive orthognathic surgery
Invasive surgery could be described as the techniques and procedures associated with surgery, anaesthetic and post-operative care that help reduce discomfort, inflammation, pain, loss of blood and complications in the patient.
At the Maxillofacial Institute we have developed and implemented various minimally invasive orthognathic surgery techniques to make operations quicker and gentler and recovery periods shorter.
What are the 5 features of minimally invasive surgery?
Precise planning and execution
3D virtual planning of movements carried out in surgery lead to the creation of facial bone repositioning guides through CAD/CAM technology. These in turn significantly help reduce surgical operation time. The Teknon Maxillofacial Institute was the first in Spain to incorporate 3D planning into orthognathic surgery, and with more than 300 cases treated using this technology, it is the most experienced with it in Europe.
Controlled hypotension and monitoring the depth of anaesthesia
Another important factor in minimally invasive surgery is anaesthesia hypotension. The meticulous blood pressure control by the anaesthetic team at the Maxillofacial Institute reduces blood loss during orthognathic surgery. Our anaesthesiologists also use BIS in 100% of orthognathic surgery cases. This is a device which uses electrodes during surgery to monitor bispectral waves linked to the depth of anaesthesia and that accurately adjust anaesthesia time to surgery time. Thanks to these techniques, at the Institute of Maxillofacial Surgery no transfusion has ever been necessary after more than 2,000 cases of orthognathic surgery. Autologous blood transfusion in orthognathic surgery: not necessary
Traditionally, the facial bones were accessed by making large incisions in the gums which, apart from causing severe bleeding and post-operation pain, compromise the blood supply to mobilised structures and may compromise bone and teeth viability. Dr. Hernández Alfaro has designed a protocol for small incisions making it possible to carry out surgery with minimum damage to tissues. His original “Twist” technique for accessing the jaw with a minimum incision (an average of 2.8 cm) and in an average time of 44 minutes has been published in the Journal of Oral & Maxillofacial Surgery "Twist Technique" for Pterygomaxillary Dysjunction in Minimally Invasive Le Fort I Osteotomy. This technique is used in procedures such as SARPE (Surgically Assisted Rapid Palatal Expansion) and, as with other interventions that use this technique, results are obtained in a very short time and there is minimal effect on the tissues.
Long orthognathic surgical operations increase blood loss, risk of infection and post-operation inflammation. Reduced surgical times can only be achieved with the experience and coordination of the team. The Maxillofacial Institute carries out an average of 5 orthognathic surgical operations a week and since 1994 has conducted over 2,000, lasting an average of 54 minutes.
Always at the forefront
Dr. Hernández Alfaro has designed and published many minimally invasive orthognathic surgical techniques in the specialism in international journals.
The Maxillofacial Institute has introduced the use of hilotherapy masks into this country to reduce post-operation inflammation for patients undergoing orthognathic surgery. This mask incorporates an internal liquid circuit which is kept at a constant 16º and which as well as reducing the appearance of haematoma also reduces inflammation and provides a feeling of wellbeing during the post-operation stage.
Finally, lymphotherapy post-operation care administered by our team of qualified therapists reduces inflammation and helps our upper, lower, and upper and lower jaw surgery patients to recover quickly.