What to expect: Carpal tunnel surgery in the clinic

So, we’re doing your Carpal Tunnel. Some patients prefer to be sedated and not
to be aware of anything with the procedure. And in that case, we can absolutely do the
procedure in the OR. (operating room) Other patients feel very comfortable, um,
we do the procedure in the office. We simply numb up the area, the same exact
procedure we would do in the OR. Except it’s a little bit less hassle for
the patient, they can come in a little bit later. They don’t have to wait around as long. It’s also safer in the sense that we don’t
require an sedation medications, which can have side effects. So I’m getting the numbing medication ready
here. This is not the needle we’re going to use
for you, we’re going to use a little, itty, bitty, skinny needle. So don’t be worried. So this is Lidocaine with Epinephrin. This is like what the dentists use to numb
things up. Kinda makes you really nice and numb, but
it also controls the bleeding. Which is what we need to do. And allows us to do the procedure here in
the office as opposed to an operating room. In the operating room, we often use a tourniquet which is like a blood pressure cuff on your arm. And that can be painful, so a lot of people
need some sedation, or sleepy medication, in order to tolerate that blood pressure cuff. So we skip the pain part. A little cleaning solution, kills the germs
that live on the skin. Alright, this is a little stick. Alright? Little stick – 1, 2, 3 (inserting needle) You alright? Getting real numb? Alright, that’s all there is to it. That’s all there is to it. That’s the worst part of today. So, we will let that numbing medication set
up. (patient) Ok. And then, we’ll wash up your hand, then we’ll do
the procedure. I think there’s all…, there’s many advantages
to doing the procedure here in the office. One of them is the cost. The cost of doing the procedure in the office
is much less than in the operating room. With a large operating room staff, anesthesia
fees, the additional fees for testing. Such as getting a pre-operative examination. Additional fees for equipment, like
placing an IV and the IV medications. Which we don’t use here in the office. Another advantage is the time savings for
the patient. Not only is the procedure a bit quicker, in
terms of not having to wait around as much, to do the procedure. In addition, patients don’t have to go visit
with their primary care provider to get pre-operative clearance. And many patients who are older and very medically
infirmed, can have the the procedure done in the office, because we are not giving those
sedation medications. Alright, and what are we doing for you today? (patient) You’re doing a surgery of the
hand, to ah, to combat the numbness of the fingers. You got it. Carpal Tunnel release surgery. Alright, everybody agree? (others in room)
Yeah. We’ll go ahead and get started here. You let me know if anything is uncomfortable
or unpleasant. (patient) Is it ok if I watch? It is absolutely ok if you watch. Just don’t lean over into the wound, ok? Did you eat breakfast today? (patient) Right, uh-huh. Yeah, did you have to…, take any, ah, did you skip any of your medications, or you were able to take them all? (patient) No, I took them all. (patient) I ate my bowl of oatmeal. (Dr. Adams) Good The nice thing about doing it here in the
office, this way, is that you don’t skip a meal, don’t have to go into the OR, don’t have
to have the medications that can make you sleepy and interfere with higher mathematical skills. And I’m going to move your nerve out of
the way. Go ahead and wiggle your fingers. Like your making a fist, see how this is moving
in the bottom of the wound? (patient) What’s that white thing? That’s the tendon, right here. (patient) Is that, does that nerve go through
the tendon? No, the nerve sits next to the tendon. The nerve is right here, and we’re just
moving it out of the way. And there’s your tendon right there. You see it moving back and forth? (patient) Ok, now, ah, um, does the nerve,
does the tendon pinch the nerve? No, they all sit under that ligament that
we cut. (patient) Oh Which is right here. (patient) uh-huh. See that right there. And also right there. (patient) So how do you get the nerve so that
it’s not being pinched anymore? We cut that ligament that was sitting on top
of the nerve. (patient) Uh-huh. The ligament springs apart and it leaves more
space available for the nerve. The ligament eventually heals or reconstitutes. (patient) Will it ever grow back so I’ll
have to have it done over again? Unlikely, sometimes it does grow back, but
it usually takes a long time. (patient) Oh, maybe one of the advantages
of being 84 years of age. The recovery after the carpal tunnel surgery
is the same, whether it’s done in the OR or in the clinic. The advantage is that you leave the clinic
here with a little carpal tunnel dressing that you take off in one or two days. Patients, in general, usually say, once they’ve
done the carpal tunnel release, I don’t know why I waited so long? Many of them have had symptoms that keep them
from sleeping well at night, for months to years. And in most cases, they’re extremely pleased
with the results of the operation and their level of pain relief. (patient) Had I known, maybe I would have
done it a year earlier. Alright, that’s all there is. We’ll put a little dressing on it and away
we go. (patient) Thank you, doctor. Your welcome. My pleasure.

11 thoughts on “What to expect: Carpal tunnel surgery in the clinic

  1. I’m surprised they are letting him watch. I had a trigger thumb release and they shielded my eyes from the procedure. My carpal tunnel started 10 years ago and got progressively worse until I could not sleep. Once the release was done the numbness was no more.

  2. I don't want Just the shot because I have carpal tunnel bad an it disturbs my sleep it is 6 months since I had it. it disturbs my sleep an it gets worse at night an it is my left hand is the worsens.

  3. Hello Doctor from any country I am from Sydney, Australia. I want you, to make the operation. My question: Will the hand be returned after the operation to the same condition? I have 12 years suffer from exhaustion, burning, convulsions and pain. It continues in the hands of the left. Is the operation dangerous
    Because I am injured in the amputation of the left leg and when i wear and remove the Artificial leg or artificial limbs
    end strongly and needed a lot to the left hand in the removal of artificial limbs Do the hand back to the same natural force after the operation and the question of what is the best way Cortisone needle or process Nador or nerve cutting and nerve editing

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