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

Suren Jengojan, Philipp Sorgo, Gregor Kasprian, Johannes Streicher, Gerlinde Gruber, Veith Moser, Gerd Bodner

Research output: Journal article (peer-reviewed)Journal article

Abstract

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.

Original languageEnglish
Article number56
Pages (from-to)56
JournalEuropean radiology experimental
Volume8
Issue number1
DOIs
Publication statusPublished - 08 May 2024

Keywords

  • Humans
  • Cadaver
  • Ultrasonography, Interventional/methods
  • Minimally Invasive Surgical Procedures/methods
  • Male
  • Female
  • Ulnar Nerve Compression Syndromes/surgery
  • Aged
  • Decompression, Surgical/methods

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