Melbourne Hand Surgery 


Latest news: Masks are and will remain mandatory when you attend our practice in person, and we request that you log your attendance via our Victorian Government QR code, by entering location code 3D7RE3 into the Services Victoria App or by writing your details on the physical register at our reception.

In accordance with the current COVID peak (black) status consultations are now being conducted via videoconference, with in person consultations by exception. Hospital elective surgery is limited to Category 1 and urgent 2A surgeries only. All individuals undergoing elective surgery are required to obtain a negative COVID test within 72 hours of their scheduled surgery and must self-isolate from the time of their test until their hospital admission. Dr Tomlinson is operating at The Avenue and Glenferrie Private. 

Videoconsultations are conducted via telehealth at our dedicated virtual clinic to maximise patient and staff safety. For in person consultations we have enhanced hygiene measures in our rooms including acrylic screens, masks, hand sanitiser, face shields and physical distancing-related changes. We require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation.      If you are eligible to get vaccinated, please do so. 

Wide awake hand surgery

What is wide awake hand surgery?

happy woman hand raised upWide awake hand surgery is performed without sedation, general anaesthesia or a tourniquet. Local anaesthetic is gently injected directly into the affected part of the wrist, hand and/or fingers. The patient is completely alert during the surgery, and after the surgery he/she can sit up and go home.

Why have wide awake hand surgery?

Wide awake hand surgery has significant benefits for elderly patients and patients with multiple medical problems because it allows the avoidance of the risks, expenses and inconveniences of sedation and general anaesthesia. While modern anaesthesia is very safe it does have risks and complications - nausea, vomiting, sore throat, shivering, damage to teeth, damage to the eye, post operative chest infection, post operative confusion, serious allergy (anaphylaxis), nerve damage, death or brain damage.

What conditions can be treated with wide awake hand surgery?

female outstretched arms in rainCanadian surgeon Donald H Lalonde reported on 1400 cases of wide awake hand surgery at the 2008 conference of the American Society of Plastic Surgeons, and uses this technique on 95% of patients in his hand surgery practice. He has used this technique for carpal tunnel surgery, trigger finger release, hand fracture reduction, extensor tendon repair, flexor tendon repair, trapeziectomies, and tendon transfers and grafts. The same anaesthetic technique is commonly used for operations on the skin, including skin grafts and local flap reconstructions.

London surgeon Mr Quamar Bismil has founded the Worldwide Wide Awake Hand Surgery Group, of which Melbourne Hand Surgery is a member. He has published extensively in this field including wide awake hand surgery for 270 patients with Dupuytren's disease (fasciectomy), and a review of 1000 wide awake hand surgery cases including carpal tunnel, Dupuytren's contracture, trigger finger, trigger thumb, ganglions (simple and complex), mucoid cysts, lumps, ulnar nerve decompression, de Quervain's decompression and injections.

Is it comfortable?

ok handsA German study reported that 83% of patients who had this type of surgery would choose to undergo it again. A UK review of 1000 patients reports >99% satisfaction. In my experience it has a high patient satisfaction rate. The local anaesthetic injections are not painless - much as it is not painless to have a needle for an immunisation or to have blood taken - but I have found that with my gentle, slow injection technique all patients who are willing to try it have been able to tolerate it without difficulty. Most patients have skin lumps and bumps removed comfortably using local anaesthetic and this is very similar.

Can I have wide awake hand surgery?

Not all surgeries are suitable and not all patients and doctors are comfortable with this technique, but if you are interested be sure to ask your surgeon!


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