Quad Cities, IL/IA

Working with the community... for a healthier community.

Procedure Inspired by Ship in a Bottle


Submitted by Orthopaedic Specialists

Dr. Jose Manuel Rojo Manaute, a hand surgeon who practices in Dubai, was inspired to develop a new minimally invasive carpal tunnel release surgery at a miniature ship model conference. Moving among the ships, he noticed some models were built inside bottles.

“It was amazing to see all the level of detail on those models,” said Dr. Rojo. “I thought—wow, this is what we need for hand surgery. We need to be able to work through a small incision—like the mouth of a bottle—and see through solid mass so we can work on the inside.”
Leaving the ship model contest, he started to think about the technology available to make this possible.

“I started thinking about what could make the skin be transparent, and that’s when I thought of ultrasound technology,” said Dr. Rojo.
He got to work. Over several years, Dr. Rojo developed and perfected an ultra-minimally invasive, ultrasound-guided carpal tunnel release that reduces the overall size of the incision and results in faster recovery times and a higher success rate for patients. He even wrote important medical papers on his findings.

Call it irony. Bad luck. Coincidence. But eventually, Dr. Rojo developed carpal tunnel syndrome himself.

Carpal tunnel syndrome is a hand and arm condition that causes numbness, tingling, and other symptoms. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist.

Though Dr. Rojo put off surgery for six years, he eventually turned to another internationally recognized hand surgeon, Dr. Tyson Cobb with Orthopaedic Specialists, to conduct the procedure on his right hand.

“I was the worst possible patient and kept pushing it off,” said Dr. Rojo. “But it really started affecting me, and I had to take action. I knew I could trust Dr. Cobb to perform the surgery on me.”

As the Director of the Hand and Upper Extremity Center at Orthopaedic Specialists, PC, Dr. Cobb is also a pioneer in minimally invasive orthopaedic techniques worldwide.

He has dedicated much of his career to becoming one of the world’s experts on minimally invasive surgery of the upper extremity and holds several patents for minimally invasive surgical equipment. He has developed and published several techniques for minimally invasive surgery of the hand and upper extremity. He instructs surgeons around the world in the use of these techniques.

Dr. Rojo recently traveled from Dubia to the United States. While in the States, he traveled to Iowa to have Dr. Cobb perform his carpal tunnel release surgery. Remarkably, Dr. Rojo used his left hand to assist Dr. Cobb in performing the ultra-minimally invasive ultrasound-guided carpal tunnel release on his right hand.

“Using the ultrasound as a guide, I cut the transverse carpal ligament, which released pressure on the median nerve and relieved the symptoms of carpal tunnel syndrome,” said Dr. Cobb. “The procedure requires only a 1 mm incision, which is much less than the incision used in traditional carpal tunnel release.”

For 72 hours after his procedure, Dr. Rojo documented his recovery. He found his experience was similar to his own patients. By using the ultrasound, recovery time was three to five times faster than traditional carpal tunnel surgery.

Immediately after the procedure, Dr. Rojo was able to use his hand for normal activities. Within 72 hours of the surgery, he was able to do push-ups and pull-ups with very little discomfort.

“I’m very happy as a patient,” said Dr. Rojo. “I sincerely feel the operation makes a very large difference for patients because it accelerates the recovery time, decreases pain, increases range of motion, and, most importantly, gives patients the ability to get back to their daily activities more quickly.”

Dr. Cobb agrees. “In the same way that the orthoscope allowed for minimally invasive procedures years ago, I believe that the ultrasound will take minimally invasive surgery to the next level,” said Dr. Cobb. “Jose has really perfected the ultra-minimally invasive carpal tunnel release.”

To learn more about Orthopaedic Specialists, call 563-344-9292, or visit OSQuadCities.com.

Photo credit: Anthony Hall/iStock

Tyson Cobb, MD,

a Pioneer in Minimally Invasive Hand Surgery

Dr. Tyson Cobb is a board-certified orthopaedic surgeon specializing in hand and upper extremity treatment. He is the Director of the Hand and Upper Extremity Center at Orthopaedic Specialists, PC, and is considered to be a pioneer in minimally invasive orthopaedic techniques.

Dr. Cobb received his medical degree from the Texas Tech School of Medicine, and he completed a five-year orthopedic residency at the Mayo Clinic in Rochester, Minnesota, followed by a Fellowship in Hand and Microvascular Surgery at the University of Texas.

Dr. Cobb is an active member of several prestigious medical organizations, including the American Association for Hand Surgery, the American Society for Surgery of the Hand, and the American Society for Reconstructive Microsurgery. He is available for interview upon request.