When Tarik Skubal was told a month into the season that he would have to get a bone chip removed from his left elbow, he expected the worst.

Skubal braced himself for the possibility of missing three months – maybe more.

“Crushed me,” he said.

Out of nowhere, Skubal received season-altering news.

Dr. Neal ElAttrache, the renowned Los Angeles-based surgeon who has operated on everyone from Kobe Bryant to Tom Brady, said he could perform a procedure using a camera the size of a pinhead. Because that camera, or scope, wouldn’t be any more invasive than, say, an injection, ElAttrache explained that his recovery time would be drastically reduced.

“I was like, ‘Yeah, absolutely,’” Skubal said. “I didn’t even need to hear anything else.”

There was one caveat: ElAttrache had never used the equipment on a high-profile athlete.

Nine days after the operation, Skubal was playing catch. About four weeks after that, he was pitching in a game.

But ElAttrache did more than save Skubal’s season. 

He might have also saved the Dodgers’ season.

About two weeks after he operated on Skubal, ElAttrache performed a more complicated procedure using the NanoNeedle Scope 2.0 on Blake Snell. 

Skubal was later traded by the Detroit Tigers to the Dodgers.

Without ElAttrache’s groundbreaking surgery, the Dodgers might not have two of their top three starting pitchers, and they certainly wouldn’t have the two two-time Cy Young Award winners pitching as well as they are now.

“Those solutions are a product of the genius of a doctor who has certainly proven to be Hall-of-Fame worthy,” said agent Scott Boras, who represents both pitchers.

Skubal estimated the surgery cost him only five starts. He pitched in 31 games in each of the last two seasons. He finished this season with 26.

“If it would have been three months,” Skubal said, “I would have missed 15, 16, 17 starts.”

That would have affected his performance.

As for Snell, he might not even be pitching now. Boras said that Snell could have been sidelined for six months if he’d undergone an operation using a traditional arthroscope.

Instead, Snell missed only half of that time and returned in the middle of August to make eight starts over the last two months of the regular season. In those eight starts, he was 4-0 with a 1.13 earned-run average.

“I just have more range,” Snell said. “Like, I can bend my elbow and throw stuff.”

Snell said his increased extension has improved his curveball by several orders of magnitude.

“The first time I threw the curveball, like, lightly, I was like, ‘Oh, it’s gonna be disgusting,’” Snell said.

Boras knew whom to call when he saw Skubal shaking his arm during a late-April start he made for the Tigers in Atlanta. Boras, who is based in Newport Beach, already had extensive history with ElAttrache, the team physician for the Dodgers and Rams. The influential agent estimates that he’s sent close to 1,000 of his clients to the celebrated doctor. 

Unbeknownst to Boras, ElAttrache was pondering potential uses for a new surgical device on the market. The NanoNeedle 2.0 was equipped with a high-resolution camera that measured only 1.9 mm in diameter, or less than half the size of a standard arthroscope. Because it required smaller incisions, it would in theory result in less swelling and bleeding which would accelerate the patient’s recovery time.

“I think it was useful especially because of the timing,” ElAttrache said. 

Shutting down Skubal for three months would require him to build up his arm strength from scratch. His season could be lost.

ElAttrache wasn’t nervous about using the technology, as he’d experimented with it enough to where he’d developed a comfort with it.

“I’ve been using the scope in my practice for 35 years,” ElAttrache said. “It’s very natural for me. It’s not like I’m learning all new skills off the bat. It’s like an experienced pitcher learning a new pitch – not learning how to pitch.”

Skubal already trusted ElAttrache, who repaired his flexor tendon and guided his rehabilitation in 2022. He wasn’t reluctant to be Patient Zero.

“I was, like, ‘Hey, if you’re confident in it, I’m confident in it,’” Skubal said.

Skubal underwent surgery on May 6. He pitched his next game on June 13.

Snell’s case was more complicated. Not only did Snell have multiple bone chips floating around, he also had bone spurs on his elbow that had to be shaved down.

Snell had experience removing bone chips before with another surgeon, and it didn’t go well. When he returned from a 2019 clean up while pitching for the Rays, he said, “My [velocity] was down and it hurt to throw.”

The discomfort was severe enough to make him consider a role change.

“I contemplated being a relief pitcher after that,” he said.

There were no such problems here.

As Boras recounted ElAttrache’s contributions in preparing his two clients for the upcoming postseason, he used the word “genius” to describe the doctor several times.

“He is very understanding of the players’ intentions and needs, in addition to those of the team,” Boras said. 

The Dodgers will now enter the postseason two pitchers they might not have otherwise. A small camera and a doctor with the necessary know-how to use it are responsible.