Leading Surgeon Responds to Nano Experience FAQs
Matt Daggett, DO, MBA, answers common Nano Experience questions.
The Nano Experience is revolutionizing how patients are diagnosed and treated surgically. Now Nano Experience surgeons can diagnose and treat injuries and ailments in an extremely minimally invasive (or MIS) way using a tiny, high-resolution camera at the tip of a wirelike device along with other arthroscopic instruments.
Nano arthroscopy, or needle arthroscopy, is an MIS treatment option that requires no incisions, has less likelihood of nerve damage,1 high patient satisfaction rates,2 and a fast recovery.2 Compared to traditional surgery, Nano arthroscopy also yields less pain,3 may require less narcotic use,4 and has additional benefits for patients.
In fact, one study reported that 94% of patients who experienced an in-office Nano procedure for ankle treatment said they would undergo the procedure again.2
- MATT DAGGETT, DO, MBA (Kansas City, MO), discusses Nano arthroscopy procedures, what differentiates the patient experience, short- and long- term effects of the procedure, and more.
How does the patient’s experience differ between arthroscopic procedures and Nano arthroscopic procedures?
Nano arthroscopy procedures are less invasive and cause less tissue damage compared to standard arthroscopic procedures. By using smaller instruments, surgeons can access more challenging areas of the joint with less chance of damaging the joint itself. Nano arthroscopy also allows surgeons the flexibility to perform these procedures with multiple anesthesia options. Some patients may require only local anesthesia, so they would be wide awake for the procedure. This may result in a quick recovery1 and a low complication rate.5
What kind of outcomes do your patients experience with Nano arthroscopy compared to traditional arthroscopic surgery?
My patients see better outcomes because of the reduced trauma from surgery, as well as the reduced amount of anesthesia they receive (during procedures in which general anesthesia is not used). In my practice, Nano arthroscopy has proven to be an even less invasive option with exceptional results for my patients.
What does the pathway from diagnosis to treatment look like for your patients?
When we obtain a diagnosis and identify surgery as the best corrective action, we discuss both the procedure itself and anesthesia options. Our goal is to do the right surgery on the right patient with the right amount of anesthesia to get the best possible outcome. Once we identify that the patient is a candidate for Nano arthroscopy, we review anesthesia options and educate the patient about the differences between those options, including local anesthesia, which allows our patient to remain awake for the duration of the procedure, or twilight anesthesia, which offers mild sedation. Once we find the best option for our patients, we discuss their recovery, the potential benefits of not using narcotics, and the postoperative plan, including what to expect on the day of surgery and in the following days.
What would a typical day look like for a patient coming in for a procedure or diagnostic assessment?
For a procedure, typically the patient arrives at the surgery center, checks in, and is escorted back to a preoperative bay. We review the plan to make sure the patient has no outstanding questions. Then an anesthesiologist sees the patient, confirms the appropriate anesthetic plan, and confirms the patient is ready for the procedure. Next, the patient is guided to an operative suite. If the patient is awake during the procedure, we discuss what would make them most comfortable; for example, they may prefer to watch a movie or listen to music. Once the procedure is complete, the patient goes home with a small bandage on the site of care. If they need physical therapy, we will determine the best time for them to start that protocol.
Do your patients typically prefer local anesthesia or general anesthesia during a Nano arthroscopy procedure? What are the advantages local anesthesia?
Currently, nearly a third of my patients prefer local anesthesia, but I anticipate an increase based on current trends in feedback and preferences. Local and regional anesthesia have fewer risks for the patient, so patient education is an important factor in selecting which method of anesthesia to use.
In your experience, do patients feel any pain during a Nano arthroscopy procedure if they and their surgeon selected local or regional anesthesia? Would their postprocedure pain differ from traditional arthroscopy pain?
A patient may feel the initial administration of anesthetic to numb the joint, but this is typically the only pain they feel during the procedure. Because Nano arthroscopy is so much less invasive than traditional arthroscopy, my patients have reported a significant difference in post-op pain compared to my patients who underwent traditional arthroscopy. Also, my Nano arthroscopy patients are more involved in the procedure.
Surgeon is a paid consultant for Arthrex Inc.
References
- Stornebrink T, Altink JN, Appelt D, Wijdicks CA, Stufkens SAS, Kerkhoffs GMMJ. Two-millimeter diameter operative arthroscopy of the ankle is safe and effective. Knee Surg Sports Traumatol Arthrosc. 2020;28(10):3080-3086. doi:10.1007/s00167-020-05889-7
- Colasanti CA, Mercer NP, Garcia JV, Kerkhoffs GMMJ, Kennedy JG. In-office needle arthroscopy for the treatment of anterior ankle impingement yields high patient satisfaction with high rates of return to work and sport. Arthroscopy. 2022;38(4):1302-1311.
- Schaver AL, Lash JG, MacAskill ML, et al. Partial meniscectomy using needle arthroscopy associated with significantly less pain and improved patient reported outcomes at two weeks after surgery: a comparison to standard knee arthroscopy. J Orthop. 2023;41:63-66. doi:10.1016/j.jor.2023.06.00
- Bradsell H, Lencioni A, Shinsako K, Frank RM. In-office diagnostic needle arthroscopy using the NanoScope™ arthroscopy system. Arthrosc Tech. 2022;11(11):e1923-e1927. doi:10.1016/j.eats.2022.07.006
- McMillan S, Chhabra A, Hassebrock JD, Ford E, Amin NH. Risks and complications associated with intra-articular arthroscopy of the knee and shoulder in an office setting. Orthop J Sports Med. 2019;7(9):2325967119869846. doi:10.1177/2325967119869846
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