Bodyjet water-assised liposuction.

This is the latest advance in liposculpture and is ideal for correcting difficult lumps of fat. It uses water in a continuous fine high-pressure spray, which breaks down the fat cells and allows them to be removed by suction. This is not to be confused with tumescent liposuction which is only used at the bginning of the operation. The operation is carried out under local anaesthetic, and the patient can direct the amount of fat to be removed.

It is NOT a weight reducing measure, and large volumes of fat will still require conventional techniques to remove.

Digital Morphing

Morphing is a computerised technique whereby the contour of a given area can be altered to a particular desired level. This is done in real-time at the time of the consultation. In the example given below, a series of four line-drawings of noses is shown of differing proportions. These have then been morphed in the next illustration to demonstrate the effect. The technique is particularly useful in contour problems such as rhinoplasty, liposuction, but caution must be stated that the results are merely an indication and not a guarantee of results that can be achieved.

Before

After

Endoscopic carpal tunnel release

Keyhole (endoscopic) carpal tunnel release was introduced in the late 1980's and was first carried out in the UK by Mr Erdmann in 1991. Since then he has carried out over 500 procedures.

The advantages of keyhole surgery are:

1. The undisputed acceleration of recovery (at 2 weeks return to office work on average, compared to 6 weeks per hand for the standard procedure).
2. Less scarring with only two small scars in the hand and the wrist.
3. Equivalent efficacy of release and no increase in recurrence rates.
4. The ability to operate on both hands at the same sitting, instead of waiting an average of 2 months between hands.
5. A light dressing is applied which is changed to two small plasters the next day. This compares with the need for a bulky bandage or plaster cast for the standard technique, needing to be worn for 10 days.

One third of patients having the open technique(standard procedure) will still have some problems at two years. These are usually either weakness of grip, significant pain in the heel of the hand on pushing off and scar tenderness. All of these problems are minimised by endoscopic surgery.

Only about 25% of patients are suitable for this technique however, with the most suitable being patients with bilateral symptoms, no previous carpal tunnel surgery or injury/fracture/scarring of the wrist, and no history of severe inflammatory arthritis eg rheumatoid arthritis.