Nicholas Genovese, M.D. · Arthroscopy
Wrist arthroscopy with possible TFCC or ligament repair
- Case time
- 60 min
- Room time
- 90 min
- First post-op visit
- 2 weeks
- Position and table
- Supine, hand table, traction tower, C-arm
- Tourniquet
- 18" arm tourniquet
- Anesthesia
- Peripheral nerve block
- Equipment and implants
- Acumed ARC wrist traction tower with finger traps
- 1.9 mm 30-degree wrist arthroscope (NanoScope if available; tower still required) and 2.7 mm 30-degree arthroscope
- Smith+Nephew Microblator 1.4 mm 30-degree coblation wand
- 2.0 mm full-radius burr and 2.0 mm (red) small-joint shaver
- Small-joint arthroscopy set, fluid pump, suction, 10 mL syringe, 18 G needle
- Wire driver; K-wires 0.045" x 6 and 0.062" x 4
- Mastisol, 3-0 Vicryl, 4-0 Monocryl, Dermabond
- In the room, not opened: 2.5 mm PushLock, 4-0 FiberLoop x 3
- Standby: Arthrex DX FiberTak double-loaded anchor (AR-8990ST-2) x 3 with DX FiberTak disposables kit (AR-8990DS) x 1
- Standby: Arthrex all-dorsal SL reconstruction InternalBrace set
- Dressing and splint
- Splint: 4" plaster, 4" Webril, 3" and 4" ACE
- Notes
- Open standby items only when requested.
Standard setup for every case
Table: almost every procedure can be done on the pre-op stretcher with a hand table attached.
Cautery: bipolar electrocautery for every case.
Tourniquet: local or MAC cases often use an Esmarch tourniquet, or a Tourni-cot for a finger. Cases under a nerve block use an 18" arm tourniquet.
Standard local: 10 mL total, 50/50 mix of 1% lidocaine with epinephrine and 0.25% bupivacaine (Marcaine) with epinephrine. Use local without epinephrine if the patient has a history of Raynaud's, and for the finger fracture and fusion cases marked "without epinephrine".
Base dressing on every wound: Adaptic, wet 4x4, dry 4x4, then the case-specific outer wrap or splint on the card.
Have available: hand tray, tourniquet, bipolar; Coban, Tegaderm, ACE wrap, Steri-Strips, benzoin or Mastisol; sutures 4-0 nylon, 4-0 Vicryl, 4-0 Monocryl, 3-0 Vicryl, 3-0 Monocryl.
Post-op appointments: most first post-op visits are at 2 weeks unless the card or the booking says otherwise. Book the first hand therapy visit at the same time as the post-op surgeon or PA visit.
Abbreviations: CRPP = closed reduction percutaneous pinning; ORPP = open reduction percutaneous pinning; ORIF = open reduction internal fixation; MAC = monitored anesthesia care; WALANT = wide-awake local anesthesia, no tourniquet.
Preference cards are a reference for operating room teams. The surgeon confirms the final plan, implants and anesthesia for each patient at booking. Questions: call the office at (858) 560-0242.
All preference cards