Endoscopic Release of the Guyon Canal and Pisohamate Hiatus

Lui, Tun Hing; Chu, Kai Man

doi:10.1016/j.eats.2019.05.033

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…As expected, damage to surrounding tissue and the skin was minimal. Similar advantages have already been described in endoscopic release of Guyon’s canal [ 22 ]. However, the potential risks of the endoscopic release, such as damage to the ulnar nerve and blood vessels, may also apply for USGTR.…”

Section: Discussionmentioning

confidence: 52%

“…Additionally, potential interactions between the palmar ulnar cutaneous and dorsal ulnar cutaneous nerves in the intervention area should be assessed to prevent nerve damage. Potential contraindications may be similar to endoscopic procedures at the canal, which are nerve compression by a solid tumor, severe hamate malunion, and pisiform dislocation [ 22 ]. Additionally, insufficient ultrasound visibility may also contraindicate the intervention.…”

Section: Discussionmentioning

confidence: 99%

“…This is attributed to the narrow anatomical space filled with important neurovascular structures, necessitating the utilization of small-caliber instruments and precise visualization of the structures. Furthermore, hydrodissection enables direct and accurate mobilization of these critical structures [ 5 , 13 , 20 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided minimally invasive thread release of Guyon’s canal: initial experience in cadaveric specimens

Jengojan,

Sorgo,

Kasprian

et al. 2024

Eur Radiol Exp

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Objective Guyon’s canal syndrome is caused by compression of the ulnar nerve at the wrist, occasionally requiring decompression surgery. In recent times, minimally invasive approaches have gained popularity. The aim of this study was to assess the efficacy and safety of ultrasound-guided thread release for transecting the palmar ligament in Guyon’s canal without harming surrounding structures, in a cadaveric specimen model. Methods After ethical approval, thirteen ultrasound-guided thread releases of Guyon’s canal were performed on the wrists of softly embalmed anatomic specimens. Cadavers showing injuries or prior operations at the hand were excluded. Subsequently, the specimens were dissected, and the outcome of the interventions and potential damage to adjacent anatomical structures as well as ultrasound visibility were evaluated with a score from one to three. Results Out of 13 interventions, a complete transection was achieved in ten cases (76.9%), and a partial transection was documented in three cases (23.1%). Irrelevant lesions on the flexor tendons were observed in two cases (15.4%), and an arterial branch was damaged in one (7.7%). Ultrasound visibility varied among specimens, but essential structures were delineated in all cases. Conclusion Ultrasound-guided thread release of Guyon’s canal has shown promising first results in anatomic specimens. However, further studies are required to ensure the safety of the procedure. Relevance statement Our study showed that minimally invasive ultrasound-guided thread release of Guyon’s canal is a feasible approach in the anatomical model. The results may provide a basis for further research and refinement of this technique. Key points • In Guyon’s canal syndrome, the ulnar nerve is compressed at the wrist, often requiring surgical release. • We adapted and tested a minimally invasive ultrasound-guided thread release technique in anatomic specimens. • The technique was effective; however, in one specimen, a small anatomic branch was damaged. Graphical Abstract

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%