Ask the Expert with Christopher Bates, MD By Kari Couret on April 11, 2022

What types of procedures are appropriate for In Office?

Many hand surgery procedures such as carpal tunnel release, trigger finger release, tendon repair, and removal of masses can now be performed under local anesthesia alone, avoiding the use of sedation or general anesthesia.

How is it performed?

The technique — known as wide-awake local anesthesia, no tourniquet (WALANT) — is performed in our office.
Local anesthesia stops all pain from the surgery.

What are the benefits of this?

The ability to safely control bleeding and extend the duration of local anesthesia allows hand surgeons to perform many procedures with minimal bleeding and without the use of sedation, general anesthesia, or a painful tourniquet.
In-Office procedures (WALANT) can also be used safely in patients who have medical complications or take blood thinner medications.

At The Hand to Shoulder Center, we want the patient to have options when it comes to their surgery. The following list represents some of the conditions that can be considered for in-office procedures.

Dupuytren's contracture release
Carpal Tunnel Release
Cubital Tunnel Release
Trigger Finger Release
DeQuervains Release
Procedures to treat Lateral Epicondylitis or Tennis Elbow
Nerve releases at the wrist and elbow
Tendon and other soft tissue procedures in the elbow, forearm, hand, and wrist

Benefits include:

Patients recover and return to normal activities faster.
Avoid side effects and complications of sedation or general anesthesia including nausea, falls, IV site pain or infection, and opioid addiction.
Costs for patients are lower.
Patients can eat and drink prior to their surgery.
Patients are not restricted from driving, as they will not be under sedation.
Allows surgeons to assess and adjust tension for tendon repairs and check the integrity of tendon repairs during the surgery due to the fact that the patient can actively move their finger.