WALANT - Wide Awake Surgery

Wide Awake surgery is a fantastic trend in the fields of hand and wrist surgery, for small hand operations.

Dr Koch is not only skilled in the field of hand surgery. But she has also performed more than 180 WALANT cases in the last year. She is actively involved in the field of Wide Awake Surgery with research. She was involved in a scientific article that showed a positive patient experience. In which the final analysis found 100 all patients preferred this method. One hundred patients were involved in this study. The average Visual Analog Scale (VAS) for pain during the surgery was 0.2/10. (This Article has been submitted for publication.)

Dr Koch is actively involved in research in this field. Furthermore, she is recognized as an accomplished surgeon in the field of WALANT. She is also, affiliated with the University of Pretoria’s Orthopaedic Department. Here she participates in pre- and post-graduate training programs for orthopaedic education.

What is Wide Awake Surgery?

Wide Awake Local Anesthesia No Tourniquet (WALANT) surgery, is a new method. This method is for performing wrist and hand procedures. The doctor makes use of local anesthesia, when performing this technique. This is different from traditional methods, where patients are placed under full anesthesia.

The advantages of WALANT surgery not only offers a procedure without general anesthesia. But also lowers the cost of your operation. And furthermore, allows for better surgical outcomes. In the past, some hand and wrist surgeries were done using a tourniquet to limit blood flow. This was in order for the surgeon to have a better view.

For patients, however, tourniquets are harsh and unpleasant. Before WALANT surgery, this discomfort was reduced by sedating patients with general anesthetics. By using the WALANT technique, the need for tourniquets and general anesthesia is eliminated. This is accomplished by using two different medications. First, Lidocaine is used to numb the feeling and block your pain. Secondly, Epinephrine is used to control bleeding, allowing tourniquets to be eliminated completely.

To learn more about Dr Odette Koch’s experience please read her bio in short here…

The benefits of this surgical method

WALANT surgery offers various benefits, such as:

There is no sedation and no tourniquet. Patient comfort and convenience is therefore improved.
The patient can flex and extend fingers, to show complete release during the surgery.
Patients are immediately discharged post-operation. Therefore allowing the patient to experience a decrease in recovery time.
The WALANT technique is more cost effective in terms of procedural expenses.

Conditions that can be treated with this method

Of course, not all hand and wrist surgery can be done using the WALANT method. Some eligible cases are:

Tendon disorders or repairs
Trigger finger release
Soft-tissue Finger lesions
Mass removal
Finger sensory block
Metacarpal fractures
Ligament repairs
Fracture fixation
Arthritic conditions
Carpal tunnel release

What about WALANT surgery attracted Dr Koch?

The Canadian, Don Lalonde, visited South Africa in February 2019. He was a guest of SASSH. Dr Lalonde’s absolute passion and excellent results convinced me to start with WALANT. I proceeded to start with it, as early as March 2019. My whole outlook on hand surgery has changed!

The patients are part of the operation. Therefore they see, for example, during a trigger finger release. Immediately, that the finger is no longer stuck, after the pully has been cut.

This has a beneficial effect on the patient’s rehabilitation. In a recent study (awaiting publication) the patients had almost no pain during the operation. Furthermore, 100% of the patients said they would do the procedure again under WALANT, if they had the choice. The positive experience is absolutely worth my while.