What is Wide Awake Hand Surgery?

A recent advance in hand surgery is Wide Awake Local Anesthesia No Tourniquet also known as WALANT.  WALANT allows your surgeon to complete surgery without the need to give medicine for sedation or anesthesia (medicine to make you sleepy). This is similar to what happens when a dentist works on your teeth.

How is this surgery different from surgery with sedation or anesthesia?

  • When anesthesia is used, a patient is not awake and cannot remember the procedure.
  • When sedation is used, a patient is awake, but given medicine to become drowsy.  The amount of medicine given will determine how drowsy the patient becomes.  The patient may remember some of the surgery.
  • When anesthesia or sedation medicines are given, the patient cannot eat or drink anything after midnight before the surgery.  An intravenous (IV) catheter is placed in a vein so the patient can receive medicine.  Lab tests or x-rays may also need to be completed before surgery and the patient may need to see their primary care doctors to prepare for the surgery.
  • With the WALANT surgery, the patient does not need extra laboratory or x-ray tests, does not need to see their primary doctor, will be able to eat and drink before surgery, and in most cases, will not need an IV catheter.

What are the advantages of WALANT for me?

You will not be given sedation medicine, so the surgery risk will be lower.  You will also be able to eat and drink on the day of your surgery.  You will not need to see your primary doctor before the surgery.  Pre-operative tests such as lab tests or x-rays will not be needed.  This will save you time and money.  You will only need an IV catheter if you require antibiotics.  Your surgeon will be able to speak with you during surgery and teach you about self-care after surgery.  You will also not need to spend time waking up after surgery, and you will leave the Surgery Center earlier than if you were given sedation medicine.

What are the financial benefits of WALANT for me?

The WALANT surgery does not use sedation medicine, pre-op testing, pre-operative visits with your primary care doctor or an anesthesiologist (a doctor who gives sedation medicine), so you will save hundreds of dollars.

Will I feel pain during the surgery?

Your surgeon or physician assistant will inject numbing medicine using a small needle into the surgical area.  The numbing medicine will be given before you enter the operating room. You will feel a small needle prick at the start of the injection. After the first needle poke, there should be no pain.  You should not feel any pain during surgery, and if you do, more numbing medicine will be given.

Will I be watching my surgery?

 You will not be able to see your surgery because a drape will block your view.  It may be possible to see the hand during the surgery and you may ask your surgeon if this is possible.

Can I get sedation medicine during the procedure?

WALANT surgery may only be performed if you commit to being awake during the surgery.  If you change your mind the day of surgery and ask for sedation medicine, your surgery date will be changed.  You cannot eat before taking sedation medicine, and you will need pre-op testing before scheduling surgery with sedation.

Has this been done before?

WALANT has been performed on thousands of patients without major problems and with high patient approval ratings.  Patients have been known to comment “I want to tell my friends about this!”

Key Benefits of WALANT Surgery

  • You will remain awake during surgery.
  • The surgery will cost about $1,000 less than surgery with sedation.
  • No pre-operative tests.
  • No appointment with your primary doctor.
  • No need to stop eating or drinking before surgery.

Click here to read our FAQ on WALANT