At the distal portion of the incision, create
access to the cubital
tunnel and locate the ulnar nerve. The Spatula
may be used to
create a space between the ulnar nerve and the
roof of the
cubital tunnel. Care should be taken to stay superficial
to the
nerve. Insert the Obturator with Handle into the
Cannula.
Lift the skin and subcutaneous tissue and insert
the Cannula and
Obturator distally into the cubital tunnel (Figure
6). Do not force
the Cannula into the cubital tunnel.
The retractor is simultaneously advanced external
to the cubital
tunnel and deep to the subcutaneous nerves/ tissues.
Remove the
Obturator with Handle.
Endoscopic Visualization
- Distally
Insert the endoscope between the Cannula and
Retractor to
confirm that no superficial nerves are in harms
way (Figure 7a)
Insert the endoscope into the Cannula. Look
through the series of slots at the inferior surface
of the Cannula to confirm that the ulnar nerve
is located directly beneath the Cannula (Figure
7b).
The Cannula may need to be rotated slightly
to capture the nerve beneath the flat surface
of
the Cannula
Confirm that the ulnar nerve is under the Cannula
throughout the entire length of the Cannula. Use
the endoscope to visualize the fascia stretched
above the Cannula.
