Endoscopic Carpal Tunnel Release System. SafeViewTM Endoscopic Carpal Tunnel Release System

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Esther Palmer
6 years ago
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1 Endoscopic Carpal Tunnel Release System SafeViewTM Endoscopic Carpal Tunnel Release System

Fully Disposable and Sterile Packaged Endoscopic Carpal Tunnel Release System SafeView is packaged sterile with fully disposable instrumentation, reducing facility costs and time associated with pre

2 Fully Disposable and Sterile Packaged Endoscopic Carpal Tunnel Release System SafeView is packaged sterile with fully disposable instrumentation, reducing facility costs and time associated with pre and post- operative set management. SafeView provides the opportunity to schedule concurrent or consecutive same day surgeries without set limitations or additional capital equipment purchases. With ergonomically designed instrumentation, multiple release options and intuitive technique, surgeons can provide their patients with a safe procedure that eliminates uncertainty and restores quality of life. 360 Panoramic Visualization SafeView provides surgeons with more control while reducing surgical complexity. Our patented clear cannula technology provides 360 of unmatched visualization and safety. The panoramic visualization is a key component to identifying significant neurovascular structures. The SafeView cannula is the industry s smallest when utilizing a 4mm scope. Surgeons will limit displacement of soft tissues structures and provide the pathway to faster recovery and return to work for their patients. Versatility and Control SafeView is compatible using a standard 4mm 30 arthroscope. The independent operation of the scope and cutting blade provides the surgeon with complete control and a generous tactile feel. Cannula includes a built-in guided track system for releasing the ligament. This system engages with the forward cutting knife for precise cutting and safety. The SafeView system includes forward and reverse cutting blades to accommodate surgeon preference. A single incision in the wrist flexion crease using both antegrade and retrograde knives is shown in the technique.

Identify the distal wrist crease, and mark 1-2 cm proximally.

Identify the volar forearm fascia, and incise in line with the skin incision.

[1] Insert the synovial elevator deep to the forearm fascia while remaining radial to the

A washboard effect will be felt as the elevator is moved longitudinally along the

[2] Antegrade Approach Rasp the undersurface of the transverse carpal ligament to clear away

Dilate the carpal tunnel space with the sequential dilators, aiming toward the third web

[3] [4] Insert the SafeView cannula, and palpate the palm to position the cannula just distal

3 Identify the distal wrist crease, and mark 1-2 cm proximally. Create a 1 cm transverse incision ulnar to the palmaris longus. Identify the volar forearm fascia, and incise in line with the skin incision. Identify and protect the median nerve at this level. [1] Insert the synovial elevator deep to the forearm fascia while remaining radial to the hook of the hamate. Palpate the distal edge of the transverse carpal ligament. A washboard effect will be felt as the elevator is moved longitudinally along the undersurface of the ligament. [2] Antegrade Approach Rasp the undersurface of the transverse carpal ligament to clear away synovial tissue and improve visualization. Dilate the carpal tunnel space with the sequential dilators, aiming toward the third web space. Insertion depth is typically between 4 5 cm. [3] [4] Insert the SafeView cannula, and palpate the palm to position the cannula just distal to the transverse carpal ligament. Maintain posterior pressure on the hub of the cannula to preserve its position beneath the ligament. [5] Insert a 4mm 30 standard arthroscope, and visualize the ligament and the deep fat distally as it overlaps the fibers of the transverse carpal ligament. Insert the reverse cutting knife volar to the arthroscope with the handle oriented parallel to the forearm. [6]

Rotate the reverse cutting knife handle by 90 (upright) to position the

Palpate the distal edge of the transverse carpal ligament.

[7] [8] Rotate 90 to upright position Insert the forward cutting knife

Retract the skin proximally, and engage the proximal edge of the

4 Rotate the reverse cutting knife handle by 90 (upright) to position the blade for cutting. Palpate the distal edge of the transverse carpal ligament. Firmly but gently withdraw the reverse cutting knife to release the distal portion of the ligament. This may help to avoid injury to the neurovascular structures located distally. Multiple passes may be necessary to ensure complete distal division. [7] [8] Rotate 90 to upright position Insert the forward cutting knife through the hub of the cannula. Retract the skin proximally, and engage the proximal edge of the transverse carpal ligament. [9] Divide the ligament under direct visualization. Following division, divide the volar antebrachial fascia with tenotomy scissors over a distance of 2-3 cm. Skin closure is achieved in the usual fashion. Apply a soft dressing. [10] innovation meets safety safeviewsurgery.com

Retrograde Approach Draw Kaplan s cardinal line from the ulnar aspect of the thumb toward the hook of the hamate. Draw a second longitudinal line proximally from the third web space.

Identify the palmar aponeurosis and enlarge the aponeurotic opening, taking care to avoid injury to the vascular arch at the distal edge of the incision.

5 Retrograde Approach Draw Kaplan s cardinal line from the ulnar aspect of the thumb toward the hook of the hamate. Draw a second longitudinal line proximally from the third web space. Create a 1cm longitudinal incision centered at the junction of these anatomic landmarks. Identify the palmar aponeurosis and enlarge the aponeurotic opening, taking care to avoid injury to the vascular arch at the distal edge of the incision. Divide the distal portion of the transverse carpal ligament. Rasp the undersurface of the transverse carpal ligament to clear away synovial tissue. Dilate the carpal tunnel space with sequential dilators. Insert the SafeView cannula. Maintain posterior pressure on the hub of the cannula to preserve its position beneath the ligament. Insert a 4mm 30 standard arthroscope, and visualize the ligament. Insert the forward cutting knife through the hub of the cannula. Retract the skin distally, and engage the distal cut edge of the ligament. Divide under direct visualization. Aim for the wrist crease just ulnar to the palmaris longus tendon. Skin closure is achieved in the usual fashion. Apply a soft dressing. SafeViewTM Components SafeView TM cannula transparent visualization Smallest cannula available using standard 4mm 30 arthroscope Built-in guided track system for precise cutting and safety Forward and reverse cutting blades to accommodate surgeon preference Synovial elevator/rasp Sequential dilators Ordering Information Part Number Description SafeView Endoscopic Carpal Tunnel Release Kit

6 innovation meets safety Mission Surgical Innovations, LLC 204 Hickory Lane Moorestown, NJ O: F: E: safeviewsurgery.com MSI Rev. A

Endoscopic Carpal Tunnel Release System. SafeViewTM 360 Panoramic Visualization Sterile Packaged Fully Disposable

U P P E R E X T R E M I T Y T E C H N I Q U E G U I D E Endoscopic Carpal Tunnel Release System SafeViewTM 360 Panoramic Visualization Sterile Packaged Fully Disposable Versatility and Control SafeView