Page 3 - Safeview - Carpal Tunnel Release - HSP 2019

Carpal Tunnel Release

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• Identify the distal wrist crease, and mark • Insert the synovial elevator deep to the forearm fascia • Dilate the carpal tunnel space with the sequential
1-2 cm proximally. while remaining radial to the hook of the hamate. dilators, aiming toward the third web space.
• Create a 1 cm transverse incision ulnar to the • Palpate the distal edge of the transverse carpal • Insertion depth is typically between 4–5 cm.
palmaris longus. ligament.
• Identify the volar forearm fascia, and incise in line • A washboard effect will be felt as the elevator is
with the skin incision. moved longitudinally along the undersurface of
• Identify and protect the median nerve at this level. the ligament.

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• Insert the SafeView cannula, and palpate the palm • Insert a 4mm 30° standard arthroscope, and visualize • Rotate 90 degrees to upright position.
to position the cannula just distal to the transverse the ligament and the deep fat distally as it overlaps • Rasp the undersurface of the transverse carpal
carpal ligament. the fibers of the transverse carpal ligament. ligament to clear away synovial tissue and
• Maintain posterior pressure on the hub of the • Insert the In-situ rasp volar to the arthroscope with improve visualization.
cannula to preserve its position beneath the the handle oriented parallel to the forearm.
ligament.

Rotate 90° to
upright position

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• Insert the forward cutting knife through the hub • Retract the skin proximally, and engage the • Following division, divide the volar antebrachial
of the cannula. proximal edge of the transverse carpal ligament. fascia with tenotomy scissors over a distance
• Divide the ligament under direct visualization. of 2-3 cm.
• Skin closure is achieved in the usual fashion.
• Apply a soft dressing.