Shoulder and Elbow Consultant Nick Ferran is a passionate advocate of awake upper limb surgery
‘It’s an extraordinary experience. I was pain-free and fascinated by the process. I was aware of him doing it, but I couldn’t feel anything.’ Rikki Stein is describing an operation to repair his torn shoulder tendon that was performed by Consultant Shoulder and Elbow surgeon, Nick Ferran. The reason for Rikki’s ‘surprise’ was that he was awake throughout the entire procedure.
‘Many patients are a little nervous about awake surgery – that’s only natural,’ says Nick, who practises at the HCA Chiswick Medical Centre. ‘However, once I’ve reassured them that they won’t feel pain – we use very effective ultrasound guided nerve blocks and extra sedation if required – and explained the benefits of remaining conscious, any anxiety is usually allayed.
‘I believe the road to recovery starts with a correct diagnosis. So, when the evidence suggests physiotherapy and injections will achieve results, I always try that route first. If, however, surgery is appropriate, then the advantages of staying awake are clear: it means avoiding the risks of a general anaesthetic – they are rare but significant – and, more commonly, post-operative nausea. Also, the pain relief can last 24 hours, patients leave hospital faster and, in some cases, rehab can begin straight away.’
During the operation Nick explains exactly what he is doing and patients can watch on screen. ‘There’s no blood, so even those who are squeamish to begin with often start asking questions. Interestingly, I’ve found that awake patients have the confidence to crack on with rehab: they don’t have to wait two weeks until their stitches come out to understand what I’ve done. They have a head start.’
While patients can choose to have a general anaesthetic if they wish, Nick now finds that most prefer the awake option. ‘The best testament is that if they return for another surgical procedure, they actually ask me for it.’
Nick describes his working methods on his youtube channel:
His specialities include:
* Clavicle, elbow and shoulder fractures and degenerative conditions
* Rotator cuff tears
* Frozen shoulder
* Ulna Nerve compression
* Tennis and Golfer’s Elbow
Nick Ferran @ Shoulder & Elbow London – HCA Chiswick Medical Centre
347-352 Chiswick High Road,