Martin Ducret, doctor and journalist at Doctor's Daily, tells us today about “office surgery”, a new type of surgery to treat carpal tunnel syndrome.
franceinfo: But before telling us about this innovative surgery, what is carpal tunnel syndrome?
Martin Ducret: It is the compression of a nerve at the wrist – the median nerve – as it passes through the carpal tunnel, which results in symptoms, particularly at night, in the first three fingers of the hand: tingling , pain, sensitivity disorders then a reduction in strength.
The treatment of this syndrome is primarily medical – stopping repetitive movements if there are any, wearing a splint, taking painkillers and cortisone infiltrations – and in the event of failure, there is no no other choice than surgery, which consists of cutting a fibrous band at the wrist, to reduce compression of the median nerve.
And this surgery can now be done in consultation, not necessarily in the operating room?
Yes, exactly. There is a new way to operate this syndrome, “office surgery”, which translates into “office surgery” because “the surgeon receives you in his consulting room, gives you local anesthesia at the level of the wrist, incises the skin, slides a sort of knife to cut the fibrous strip using an ultrasound device as a guide, removes the knife, and encloses the incision”, Dr Alexandre Laborde, orthopedic surgeon at the Beausoleil clinic in Montpellier, explained to me.
This technique takes less than 30 minutes, and the patient can go home with both hands functioning normally.
The main advantage of this surgery is that it is more comfortable for the patient than the classic ambulatory surgical technique. ?
Yes. The most common method – endoscopic incision – requires locoregional anesthesia of the entire arm, by an anesthetist in the operating room. The surgical procedure itself is quick, but the patient must first consult the anesthesiologist, sometimes stop treatments, then come early in the morning on an empty stomach, then wait to have the operation during the day, before returning home with the arm more or less asleep.
“Office surgery” frees itself from all these constraints, thus offering real comfort to the patient with equivalent results, provided of course that the surgeon is well trained. In addition, it makes it possible to reduce the financial cost and the carbon impact, which is not negligible, when we know that carpal tunnel surgery concerns more than 130,000 patients per year.
