10087309Novel techniques of percutaneous sonography-guided surgical operations (SonoSurgeryActiveCollaborative R&DInnovate UKA Swiss company, Spirecut, has developed an innovative way to treat carpal tunnel and trigger finger using patented instruments (Sono-Instruments) and an incisionless technique conducted under ultrasound. Patients can be treated in an outpatient clinic in under 10 minutes, with no stitches and can resume normal activities immediately. In the current climate, with great strain on NHS resources and growing waiting lists for routine operations (over 7 million on NHS waiting list), this novel technique has the potential to reduce costs, improve NHS efficiency and get patients back to work faster, helping the economy post Covid. In this project, a collaborative UK-Swiss team will work to extend the Spirecut approach to other patient groups. The UK distributor of the Sono-Instruments, Sovereign Medical and health economists at the University of Southampton will work in partnership with Spirecut in Switzerland to conduct research on the extension of this technology for other conditions, such as Dupuytren disease, De Quervain and tennis elbow. Sovereign Medical will lead on recruiting to a joint UK-Swiss panel of expert advisors, including orthopaedic surgeons and interventional radiologists, who will assess suitability of the Spirecut technology these additional uses. The advisory group deliberations and consultations with a wider group of clinicians in a Delphi exercise will be used to assess the technical feasibility of the potential indications, and the economic impact that adopting these techniques would have on health services and medical innovation. The health economic team at Southampton will develop a model to aid decision making about further research and investment. The model will provide estimates of market value for each indication from a commercial perspective and estimates of budget impact and cost-effectiveness for the NHS. These estimates will be based on published information, real-world evidence sources and expert opinion, and will be updated as results from the Swiss clinical studies become available. This will provide a foundation for a future submission to the National Institute for Health and Care Excellence (NICE) with the aim of obtaining a recommendation for NHS adoption.