Name: Carpal Tunnel Release
Uploaded: 2024-06-01T00:00:00.0000000
Duration: T00H04M58S
Description: Carpal Tunnel Release

Name: Carpal Tunnel Release

Description: Carpal Tunnel Release

Thumbnail URL: https://cadmoremediastorage.blob.core.windows.net/eeb3aa1a-dac7-4491-b1d3-fd7aa52b934f/videoscrubberimages/Scrubber_1.jpg

Duration: T00H04M58S

Embed URL: https://stream.cadmore.media/player/eeb3aa1a-dac7-4491-b1d3-fd7aa52b934f

Content URL: https://cadmoreoriginalmedia.blob.core.windows.net/eeb3aa1a-dac7-4491-b1d3-fd7aa52b934f/Carpal Tunnel Release.mp4?sv=2019-02-02&sr=c&sig=lr8REQRmJPvdIZMEh%2FbxAaFDJ06E2Bvgk%2FJVz2aW2ac%3D&st=2024-12-04T08%3A43%3A20Z&se=2024-12-04T10%3A48%3A20Z&sp=r

Upload Date: 2024-06-01T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
This is a short video on carpal tunnel release performed by Professor Bijayendra Singh, done under local anesthetic. I use 10 mils of 1% xylocaine with adrenaline injected five minutes before I perform the incision. WHO check has been done. Patients' on table.
I'm marking the Kaplans line. So along the horizontal line of the thumb and the third web space. And I generally try and take the crease if there is one. Always draw my incision. And before I make an incision, I check, that's the normal, checking with the patient.
Assuring the patient. Then incise. Size 15 blade the skin and then at this stage, I do not spend too much time with the hemostasis but do a spread with scissors and then use a self retaining retractor, which acts as a hemostasis.
If required, I might release the incision so it's not under pressure. And then going through the fascia and I come to the transverse carpal ligament. And at this stage, I again reinsert the retractor deeper and now I would go in and incise at one point to, like, go through the full thickness of the fascia so I know how much depth I need to go.
And once I reach that, with one sweeping incision, I release the full thickness, both distally and proximally till I can see under direct vision. At this stage, I would get my assistant to hold a retractor and I would check with the patient. Once they are happy, then I release it. This is vitally important, as, if the patient complains
of pain if the branch of the median nerve is erroneously placed and this reduces the chance of getting injury to the superficial arm or branch of the median nerve. And that is it. Make sure that I've performed adequate release distally and you can see the median nerve and make sure that there is
enough space, both proximally and distally. Remove the retractors and then get adequate haemostasis using bipolar diathermy. Generally not a great deal of bleeding with the use of the adrenaline. I use a 4-0 nylon to close the skin interrupted sutures.
First one goes in the center of the incision. And then I go halves, only this side. You generally end up with about seven sutures in most of the carpal tunnels.
As you can see, this procedure does not take a very long time. Key is to avoid going into the crossing the wrist otherwise, it can cause a painful scar and a thickened scar occasionally and the last stitch going in.
The whole procedure takes under 10 minutes. The wound has been cleaned apply a tegaderm adhesive dressing followed by a pressure dressing and the patient is given post-operative advice. Post-operative advice is adhesive dressing and a soft bandage is applied. Patients allowed to mobilize fingers and hands as comfortable and the suture removal is performed at two weeks time.

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