CT man watches his own surgery in real time without general anesthesia. Here’s why and how.

Hartford Courant – Monday, February 24, 2025
By Pamela McLoughlin

Imagine having ankle surgery without general anesthesia, watching the whole procedure in real time, then walking out of the procedure on that very ankle.

That’s just what patient Bill Segraves of Guilford was able to do at Yale New Haven Hospital recently because his orthopedic surgeon, Dr. Arianna Gianakos has special training in the technique.

It can work for shoulders and knees too.

Yale New Haven became the first hospital in Connecticut in which a doctor perform an awake ankle arthroscopy using needle arthroscopy, a minimally invasive technique that can treat a wide range of orthopedic conditions, a hospital spokesperson said.

Gianakos used a 1.9 millimeter camera through small incisions to do the surgery, no sutures needed. And only local anesthesia.

After the surgery people can return to work, life, and sports with fewer complications, Gianakos said.

And there are none of the risks of general anesthesia, including complications such as blood clots or the need for narcotic pain killers.

Patient Segraves said the ankle was “sore” for 24 hours and lessened each day.

Gianakos said the long range plan for the type of surgery is to get used to moving it from a surgical suite to a procedure room, to the office.

“I was really glad to be part of that progression because I thought it was really interesting,” Segrave said, of watching his own surgery in real time. “It was the best option to get me back to the things I like doing for many years to come.”

Segraves, who is in his 60s but extremely physically active, damaged his leg and ankle in 2023 while hiking in Montana when he slipped on wet vegetation. He was able to walk enough to get to safety. It turns out he had broken a bone in his leg and damaged his ankle. The leg healed more easily than the ankle.

“I can’t wait to be back in the woods with a backpack and want to race my bike up the mountain,” he said.

Segraves was a “great candidate” who even spoke during surgery and watched, although that’s optional, the doctor said.

Gianakos, who was specially trained by another doctor in New York, said she’s trying to promote the technique in Connecticut.

“This new technology can benefit our patients, by providing a minimally invasive alternative treatment without the use of general anesthesia affording patients the ability to return to work and return to sport in a safe and efficient manner,” Gianakos said. “Ultimately, we plan to translate this care from the operating room setting to in the office setting (in-office nano arthroscopy, IONA).”

“We are breaking new ground with these procedures allowing patients to be engaged during their procedure. In addition, patients are able to return to their day to day activities much quicker,” Gianakos said.

Not everyone would be interested in watching their own surgery, but Segraves has a biology-related career background and said he enjoyed that aspect.

“I could see everything happening it was incredibly cool to watch. I could see what looked good,” he said. “It was remarkable to see her surgical skills as she cleaned up my ankle.”

He said it was also great to “get back to doing things quickly.”

He said Gianakos has great training, enthusiasm, understanding, and “it was nice working with her.”

Gianakos said she had been waiting for the “perfect patient” to perform the procedure in Connecticut and he was it.

“I’m trying to get other surgeons to do this,” she said.

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