77th ASSH Annual Meeting - Back to Basics: Practice and Education-IC05: WALANT Beyond Carpal Tunnels and Flexor Tendons (AM22)

Video Transcription

Video Summary

The surgeon in the video discusses the benefits of performing hand surgeries under wide awake surgery (Welland), allowing the patient to be awake throughout the procedure. This technique eliminates the need for general anesthesia and tourniquets, opening up new possibilities for a variety of hand surgeries. Epinephrine can be used for local vasoconstriction, and lidocaine with epinephrine is safe for finger surgeries. Welland has been successful for soft tissue coverage, nerve procedures, and various other hand surgeries. The advantages of Welland include reduced postoperative swelling, improved patient compliance, and quicker recovery times. The video also focuses on the use of local anesthesia for flexor tendon repair, thumb basal joint arthroplasty, and wide awake tenolysis. The panelists share their experiences and techniques for performing these procedures under local anesthesia, highlighting the benefits of patient preference, lower risk, flexibility, and cost savings. They discuss challenges and considerations, including ensuring sufficient pain management and obtaining approvals. Tips for successful implementation include patient education and demonstration, as well as negotiation with payers. Overall, both the surgeon and panelists emphasize the advantages of using local anesthesia for appropriate cases, providing increased patient autonomy, faster recovery, and improved resource allocation.

Meta Tag

Session Tracks Arthritis

Session Tracks Fracture

Session Tracks Practice Management

Session Tracks Skin Soft Tissue

Speaker Gregory Paul Kolovich

Speaker Orrin I. Franko, MD

Speaker Sara M. Guerra, MD

Speaker Steven M. Koehler, MD, FAAOS

Keywords

hand surgeries

wide awake surgery

local anesthesia

epinephrine

lidocaine with epinephrine

soft tissue coverage

nerve procedures

postoperative swelling

patient compliance

recovery times

flexor tendon repair

patient autonomy