What Are WALANT Procedures for Hand and Wrist Conditions?

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David Tuckman, MD

Dr. David Tuckman is a Hand & Upper Extremity and Sports Medicine Surgeon at Orthopaedic Associates of Manhasset.

A Q&A with Dr. David Tuckman, Hand & Upper Extremity and Sports Medicine Surgeon at Orthopaedic Associates of Manhasset.

Please explain what WALANT surgery is and how it differs from traditional orthopedic procedures.

WALANT stands for Wide Awake Local Anesthesia No Tourniquet, and it’s a technique for office-based surgery primarily used in hand and wrist procedures. WALANT is performed under local anesthesia, without the tourniquet or general anesthesia traditionally used in these procedures.

What are the benefits of WALANT to patients?

Patients benefit from WALANT in several ways:

No pre-surgical testing is required.

Patients do not need a potentially painful IV or intravenous medication.

They do not feel any pain during the procedure.

Patients can remain clothed throughout the procedure.

Because general anesthesia is not used, patients can drive themselves to and from the office for the procedure if they wish.

WALANT does not require lengthy pre- and post-operative stays in a hospital or surgical center. The procedure itself takes about five minutes, and from start to finish, patients typically spend 20 to 30 minutes in the office.

WALANT costs significantly less than traditional techniques, with no need to pay an anesthesiologist and no hospital fees.

Do patients feel any sensation or pain during WALANT surgeries?

Patients do not need an IV and intravenous medications, which have potential side effects. They will only feel a small pinch when local anesthetic is administered. Patients do not feel any pain at all during the procedure.

How do patients typically respond to being awake during surgery?

I have had multiple patients who have previously undergone procedures in an operating room. They have expressed how much they love the WALANT experience because it is pain free and convenient, with the same or better results as procedures done in a traditional operating room. Patients are very relaxed and comfortable during the brief WALANT procedures.

What types of orthopedic surgeries are most commonly performed using WALANT?

Common surgeries using WALANT include:

Carpal tunnel release

Trigger finger release

Cyst excision

Dupuytren’s contracture release

Dequervain’s release

Mass/lump excision

What kind of training or experience is needed for a surgeon to perform WALANT procedures?

I am a fellowship-trained, board-certified Orthopedic Hand Surgeon, with twenty years of experience. I am also the Past President of the New York Society for Surgery of the Hand.