​Donald Lalonde – Personal profile and master videos

Donald Lalonde – Personal profile and master videos

Donald Lalonde, MD is a professor of surgery at Dalhousie University Medical School and is an attending plastic surgeon at Saint John Regional Hospital, St. Joseph’s Hospital and Sussex Community Health Centre. He has four main areas of research: wide awake reconstructive surgery, minimal pain injection of local anesthesia to avoid the need for operative sedation, pain guided hand therapy and evidence-based operative sterility. He has been invited Visiting Professor more than 35 times to various Plastic and Orthopedic surgery training programs in Canada and the United States, invited speaker for more than 200 International presentations with many being the keynote speaker and more than 100 peer reviewed journal publications and 10 book chapters.

https://medicine.dal.ca/departments/department-sites/surgery/divisions/plastic-reconstructive-surgery/our-people/our-faculty/don-lalonde.html

https://twitter.com/drdonlalonde

Master videos
Wide awake hand surgery
General principles
Introduction
Introduction to wide awake hand surgery.

Washing a contaminated hand in a wide awake patient in the emergency department

Safe epinephrine in the finger means no tourniquet
History of the rise and fall of the epinephrine danger myth

How to reverse epinephrine vasoconstriction with phentolamine injection in the finger

Tumescent local anesthesia
Principles

How to inject local anesthetic with minimal pain
How to inject local anesthetic with minimal pain

Patient’s pain impressions after a “hole-in-one” local anesthetic injection for carpal tunnel surgery

How and why to buffer lidocaine with epinephrine

How to perform a SIMPLE block

A two dorsal injection block hurts more than a SIMPLE block

Systemic adverse reactions to lidocaine and epinephrine
Lowered epinephrine concentration for cardiac issues

Managing the vasovagal fainting attack

Talking to patients about WALANT
Explaining WALANT to a patient

When patients are unsure about remaining awake

Patient impression of pain of a local anesthetic needle versus an intravenous needle

Talking to patients during surgery saves time
Advice to patient during skin cancer excision in the hand

During surgery the patient can verify that the deformity has been corrected

Advice to a patient while K-wiring a finger fracture

Advice to a 10-year-old during flexor tendon repair

Giving intraoperative advice during carpal tunnel release

WALANT hand surgery in infants and children
Flexor tendon repair in a 6-year-old girl

Excision of a fifth finger nubbin in a 4-week-old infant

Safety and value of field sterility
Safety and value of field sterility for hand surgery

Obtaining buy-in for WALANT
Why patients love WALANT

Scheduling 15 or more hand surgery cases a day with WALANT
Three carpal tunnel procedures performed per hour

Integrating hand therapists into WALANT
Patient watching structures being repaired

Teaching a patient during flexor tendon repair surgery

Allowing wrist extension and active flexion after flexor tendon repair

Relative motion extension splinting for extensor tendon repair

Early protected active motion after K-wired repair of finger fractures

Early movement 3 days after K-wiring finger fractures

Minor procedure room set up
At the Saint John Regional Hospital

At St. Joseph’s Hospital

Accredited operating room at Dr. Lalonde’s office

Specific procedures: Finger and ray amputation
Local injection for proximal phalanx finger amputation
Local injection for proximal phalanx finger amputation

SIMPLE block for distal phalanx squamous cell cancer amputation
SIMPLE block for distal phalanx squamous cell cancer amputation

Specific procedures: Nerve decompression
Carpal tunnel decompression of the median nerve
Patient impression of tourniquet with sedation versus WALANT for endoscopic carpal tunnel surgery

A “hole-in-one” minimal pain local anesthetic injection for open carpal tunnel release

Blunt-tipped cannula injection of local anesthetic for carpal tunnel surgery

Injecting local anesthetic for endoscopic carpal tunnel release

Patient consultation for carpal tunnel surgery

Advising the patient after injection of local anesthetic for carpal tunnel release

Intraoperative advice to the patient during carpal tunnel surgery

Field sterility setup for open carpal tunnel release

Carpal tunnel surgery (Lalonde)

Endoscopic carpal tunnel surgery

Cubital tunnel decompression of the ulnar nerve
Checking for ulnar nerve subluxation with active movement during surgery

How to inject local anesthetic for cubital tunnel release at the elbow

Real-time injection of local anesthetic for cubital tunnel release

Injecting for both cubital tunnel and carpal tunnel release in the same operation

57 mm blunt-tipped 22-gauge cannula injection of local anesthetic for cubital tunnel release

Prepping and draping for a WALANT cubital tunnel ulnar nerve release

Cubital tunnel surgery with WALANT

Lacertus syndrome: media