Pros of Minimally Invasive Achilles Surgery 

• A smaller incision is associated with better healing, as there tends to be less wound complication.
• Generally, procedures with less wound complication lead to a faster recovery, but that is not always the case.

Cons of Minimally Invasive Achilles Surgery

• Visualization of the tendon edges during surgery is harder.  Because of this, nerve injury rates are higher during a minimally invasive procedure.
• In a small number of cases the surgeon finds that the Achilles is more damaged than originally thought, which means a more invasive procedure is necessary.
• Because of the nature of the procedure, the patient must be asleep and lie on their belly with a tube down their throat to protect the airway.  Anesthesia risks are slightly higher with this type of procedure.
• Minimally invasive surgery is more costly than a more invasive procedure.

Bottom line 

Doctors who can carefully perform Achilles surgery with minimal soft tissue trauma can usually get the same results as a minimally invasive procedure with less expense and less risk.  Even in a more invasive surgery, if the doctor treats the skin and underlying tissues with care and uses the latest generation of stitching techniques, the patient can begin weight bearing the day after surgery.  Training without explosive sprinting can begin as early as 8 weeks, and athletes can get back to their sport after 4-5 months with an accelerated rehabilitation program.

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