This incisionless release — known as thread ultrasound-guided carpal tunnel release (TCTR) — uses an abrasive thread looped percutaneously to dissect the transverse carpal ligament (TCL) and is performed using local anesthesia.
Utilizing ultrasound critical structures such as nerves and blood vessels are identified after local skin anesthesia. A specialist needle is inserted under the ligament, causing compression of the nerve. A cutting thread is then placed through the needle utilizing the same entry and exit site. The needle is then passed above the ligament. The cutting thread is then placed through the needle. This loops the ligament with the cutting thread, avoiding critical structures. The cutting thread is then placed with a protective device and handles applied to the end using a to and fro motion. The ligament is cut to relieve pressure on the nerve bandages are applied after the procedure.