this is Nicole deal in this video will
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take you through my approach for many
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open carpal tunnel release surgery you
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see here we've drawn our incision in
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line with the radial border of the ring
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finger approximately one centimeter
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distal to the wrist crease for the
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purpose of illustration for the video
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our incision is made larger than our
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typical incision which is about a
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centimeter in length the incision is
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made through the skin
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any superficial cutaneous vessels are
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coagulated and then using blunt
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dissection soft tissue is spread down to
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the transverse carpal ligament using a
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knife here we're just dissecting through
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some of the palmar fascia down to the
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transverse carpal ligament
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the transverse carpal ligament is open
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using the knife and then using
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strabismus scissors is sharply
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transected under under act visualization
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here you can see the median nerve at the
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base of the incision and trans section
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of the transverse carpal ligament
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approximately at the wrist
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once the transverse carpal ligament is
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completely transected the median nerve
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itself is inspected you can frequently
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see increased vascularity of the nerve
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as you do here in this median nerve with
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a vascular stripe along the epineurium
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the wound is then irrigated and the
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incision closed using an absorbable
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suture
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postoperatively the patient begins
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immediate range of motion and a soft
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dressing is applied during in the
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operating room