This time, Dowling was under the care of fellowship-trained Tidelands Health orthopedic surgeon Dr. Jesse Lewis, who specializes in the hand and upper extremities.
Dr. Lewis, who practices at Tidelands Health Orthopedics at Murrells Inlet, says Dowling underwent a relatively new approach to carpal tunnel syndrome that allows the surgery to be performed without full anesthesia or a tourniquet.
Known as the “wide awake local anesthesia no tourniquet,” or WALANT, approach, the procedure involves injecting the wrist with numbing agent and a medicine that constricts the local blood vessels, the physician explains. Through a small incision in the palm, the carpal tunnel is released, taking pressure off the inflamed nerve and allowing it to heal.
Carpal tunnel release remains one of the most common surgeries in the U.S., and Dr. Lewis performs several of the nerve releases per week.
Dr. Lewis has adopted the WALANT approach for as many procedures as possible, including nerve decompression, trigger finger releases, hand mass excisions, tendon repair and even some fractures.
Having the patient awake allows the physician to talk with and educate the patient during the procedure and check repairs with active patient participation, he says.
“It’s also nice for the patient to avoid the side effects of IV sedation, and it allows me to operate on patients who can’t be put under full anesthesia for medical reasons,” the physician says.
Recovery time is individualized based on the severity of the nerve injury and other personal factors. He advises patients to keep the surgical incision dry for three days and then remove gauzing and perform activities as tolerated. After two weeks, sutures are removed.
“I have patients who come back at two weeks and tell me they’ve already been trying to do things such as golfing, but most patients probably are not up to all activities until 4-6 weeks,” Dr. Lewis says. “However, I do not put any restrictions on patients.”
The nerve continues to heal for more than a year, though most people experience improvements well before it’s fully healed.
Dowling said he had worried about pain after the surgery, but he never even needed the pain medication Dr. Lewis prescribed.