Anatomical orientation through palpation and marking of anatomical landmarks:
- Planning mini-incision with incision line in the extension line of the middle of the 3rd/4th finger ray to the ulnar insertion of the palmaris longus tendon at the aponeurosis (guiding structure)
- Incision in the median palm about 2-3 cm long (mini-incision) starting approximately 1.0 to 1.5 cm distal to the wrist crease
- Sharp transection of the subcutis under bipolar coagulation of individual veins
- Exposure of the palmar aponeurosis
Tips for orientation
- Orientation of the carpal tunnel based on palpable pisiform bone and scaphoid tubercle
- Flexor retinaculum begins at the level of the wrist crease
- Orientation of the course of the median nerve between the flexor carpi radialis tendons and the palmaris longus tendon