Office-Based Surgery: Toward a New Model for Hand Surgery in France

Hand surgery is currently undergoing significant changes in its practices. Among these, Office-Based Surgery (OBS) is gradually emerging as a new way to organize certain procedures, emphasizing simpler, faster, and patient-centered care pathways.

To support this development, a national working group recently drafted the first French guidelines for the practice of office-based surgery in hand surgery.

I had the honor of serving as rapporteur for this working group, alongside Drs. Olivier Marès, Thomas Appard, and Gilles Candelier.

On January 17, 2026, we presented these recommendations at a hearing before the French Society of Orthopedic and Traumatological Surgery (SOFCOT) and the National Professional Committee (CNP). The professional societies are currently continuing their validation process.

What is Office-Based Surgery?

Office-Based Surgery involves performing certain procedures directly within a specially equipped medical office, in a safe environment that meets strict quality and safety standards.

This approach is made possible by advances in minimally invasive surgery, ultrasound-guided surgery, and local anesthesia techniques, particularly the WALANT method (Wide Awake Local Anesthesia No Tourniquet).

Obviously, not all procedures are included, but many hand conditions can now be treated using this approach.

What are the benefits for patients?

The goal of this change is not merely organizational. Above all, it aims to improve the patient experience.

Office-Based Surgery offers the following benefits, among others:

• care provided in a simpler and more reassuring environment;

• local anesthesia, which in many cases eliminates the need for general anesthesia;

• a shorter course of treatment;

• a functional recovery that is often faster;

• a same-day return home.

For patients, this means fewer restrictions while maintaining a high level of safety.

Changes in Medical Practices

Already widely practiced in several countries, office-based surgery represents a natural evolution of hand surgery.

It is based on specific patient selection criteria, rigorous organization, and validated protocols.

The recommendations currently undergoing validation will help harmonize practices and support the development of this approach in France.

A collective effort

These recommendations are the result of a collaborative effort involving several surgeons committed to this evolution in clinical practice.

The goal is shared: to provide a framework for developing surgical procedures that are increasingly safe, effective, and tailored to patients' expectations.