This video contains graphic footage of a real live surgery meant for educational purposes and may not be suitable for all audience. Viewer discretion is advised.

For an appointment with NUH, visit
https://www.nuh.com.sg/patients-visitors/Appointments/Pages/default.aspx

To contact the Department of Hand and Reconstructive Microsurgery at National University Hospital (NUH), Singapore, please email hand_enquiries@nuhs.edu.sg

To watch the 3D animation of the procedure instead, click on this link.
https://www.youtube.com/watch?v=jJln40MOkto

To watch Carpal Tunnel Release Surgery - Post Surgery Care Advice, click on this link
https://www.youtube.com/watch?v=sgMKaJsPSR0

In this in-theatre live surgery video, we take you into the operating theatre to watch Professor YT Lim, Senior Consultant, Department of Hand and Reconstructive Microsurgery, National University Hospital (NUH) Singapore, perform a carpal tunnel release surgery.

It is a day surgery procedure done under local anaesthesia.

Steps of the surgery:
- The distal edge of the incision is found by palpation from the fat pad to the transverse carpal ligament. The incision is usually about one and a half to two centimetres long.

- The median nerve is blocked at the proximal wrist crease and the line of incision is anaesthetised with a combination of lignocaine and adrenaline.

- An incision is made in the longitudinal palmar crease which is in line with the radial border of the ring finger.

- The incision is deepened through blunt or sharp dissection and the palmar fascia is exposed.

- The next layer is the transverse carpal ligament itself.

- The plane above the transverse carpal ligament is developed. The ligament is incised in line with the radial aspect of the ring finger.

- The transverse carpal ligament is then incised and the carpal tunnel entered. The proximal edge of the carpal tunnel is completely released with Metzenbaum scissors.

- The proximal release is confirmed by opening the scissors and the distal release is confirmed by visualising the fat pad in the wound.

- Sometimes there are remaining fibres that need to be incised.

- Occasionally, an external neurolysis is indicated where there is extensive synovitis around the nerve.

- Finally, the incision is closed with sutures and a compression bandage applied for the next few days.

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About National University Hospital (NUH) (Singapore):
NUH is Singapore's major tertiary hospital and referral centre with over 50 medical, surgical and dental specialties. It is the only public hospital in Singapore to offer a comprehensive suite of specialist care for adults, women and children as well as paediatric kidney and liver transplant programme, in addition to kidney, liver and pancreas transplantations for adults.