Milwaukee VA at forefront of groundbreaking carpal tunnel procedure
A groundbreaking surgery that can have carpal tunnel sufferers back at work in a matter of days instead of weeks or months is being performed at the Milwaukee VA Medical Center.
In fact, the Milwaukee VA is the only hospital in the Midwest doing the procedure and one of only two VA hospitals in the country offering it.
The procedure is so minimally invasive that an Emergency Department doctor at the Milwaukee VA had the operation on a Thursday and was back at work two days later.
“The recovery was incredibly easy,” said Dr. Jonathan Wiese, who had the procedure on both wrists a few weeks apart. “I only took Tylenol and ibuprofen for the pain; I didn't have to take anything stronger than that.
“I did wear a brace to sleep for the first couple of nights, just to provide a little bit of support. But I was back to doing pretty normal activities within a week or two.”
The procedure -- carpal tunnel release with real-time ultrasound guidance – relies on a device developed by Sonex Health that allows the surgeon to see the nerves without a major incision.
The incision for the procedure is only about 4 millimeters – much smaller than the traditional surgery.
“When I was training last century, we made big incisions, and we flayed people from the palm down to the wrist,” said Dr. William Dzwierzynski, chief of plastic surgery at the Milwaukee VA. “It can be a painful scar.
“Using the device … I can see the nerve and the ligament through the small incision. I can see the branches of the nerve and the artery. That gives it added safety, along with the benefit of a smaller incision and faster return to activities.”
Carpal tunnel syndrome is caused by nerve compression in the hand and wrist, and it affects about 13 million people in the United States, Dzwierzynski said. About 500,000 carpal tunnel surgeries are performed annually.
If left untreated, carpal tunnel syndrome could lead to permanent nerve injury, Dzwierzynski said, which could lead to atrophy of the muscles and the loss of strength and sensation.
Before his surgeries, Wiese said he was experiencing “terrible pain and numbness” in his hands. “It was especially bad driving to and from work. And it would wake me up, sometimes a dozen times a night.”
During surgery, the doctor loosens a band that is pressing on the nerve and cutting off the blood supply to the nerve.
“Carpal tunnel surgery basically opens that band and frees it up so the nerve … can function like a nerve normally does,” Dzwierzynski said.
According to Sonex Health, based in the Twin Cities, many people with carpal tunnel syndrome “decline or delay surgery due to fear of surgery, long recovery time and economics.”
In addition to the shorter recovery time and small incision – that can be closed without sutures -- carpal tunnel release with real-time ultrasound guidance offers other benefits:
- It can be performed in a procedure room or office setting.
- It is typically performed using local anesthesia.
- There is immediate motion in the hand for rapid recovery.
- Postoperative therapy is typically not required, saving time and money.
- The need for opioids after the procedure is reduced or eliminated.
Dzwierzynski, who has done thousands of carpal tunnel surgeries during his career, said this latest evolution is a major step forward.
“I think it’s exciting,” he said. “I think this is a device that offers incredible advantages to the patients. It gives them a faster recovery and a safer procedure.”