--- title: 'Ultrasound Guided Carpal Tunnel with McGinley Augmented Reality' type: 'lecture' url: 'https://doc.social/lectures/ultrasound-guided-carpal-tunnel-with-mcginley-augmented-reality' published: '2020-10-29' author: 'McGinley Orthopaedic Innovations' specialty: 'General Orthopedics' topics: 'Ultrasound, Technology, Carpal Tunnel' transcript: 'yes' --- # Ultrasound Guided Carpal Tunnel with McGinley Augmented Reality ## Summary Watch as Dr. Joe McGinley performs carpal tunnel release utilizing the McGinley AR technology. The latest in ultrasound technology, the McGinley AR overlays the ultrasound image onto the physical anatomy of the patient, providing ergonomic benefit to the physician. In real time, the physician is able to simultaneously see the critical anatomical structures and the ultrasound image. This enhances the comfort of the physician and the safety of the patient. To learn more, visit [www.TheMcGinleyClinic.com](http://www.TheMcGinleyClinic.com) or call 1-866-678-4699. ## Transcript 905 words · 6 min · 2 speakers · automatically transcribed (aws-transcribe) and not checked by a person; it may contain errors, particularly in names, drugs and dosages. The recording is the source. [0:00] Speaker 1: The McGinley Clinic presents Ultrasound guided Carpal tunnel release utilizing the McGinley Augmented reality for Ultrasound system. This minimally invasive procedure is used to treat Carpal Tunnel syndrome. Used in conjunction with the McGinley Augmented reality for Ultrasound during this procedure, the SX1 microknife further enhances the safety and recovery for the patient. [0:20] Speaker 2: According to published studies, Carpal Tunnel syndrome affects more than 12 million Americans, causing Pain and keeping people from work and leisure activities. [0:30] Speaker 1: Carpal Tunnel syndrome is a common condition with symptoms of Pain, numbness, and tingling in the hand. The condition occurs when one of the major nerves in the hand, the median nerve, is compressed as it. [0:41] Speaker 1: Travels through the wrist. The median nerve controls movement in the thumb and feeling in the thumb, index finger, middle finger, and half of the ring finger. It runs down the arm and forearm, passes through the Carpal Tunnel at the wrist, and goes into the hand. [0:55] Speaker 2: Traditionally, the open release procedure performed in the operating room has been the standard of care for treating Carpal Tunnel syndrome. Over the past 10 years, laparoscopic release procedures performed in clinics using local anesthesia have surged to the forefront. [1:10] Speaker 2: The latest technological development in Carpal tunnel release utilizes Ultrasound and a minimally invasive guided technique with the SX1 microknife. This procedure is performed in an Outpatient setting with local anesthesia only. The patient is completely awake and does not require sedation or a regional nerve block. Compared to open or endoscopic release, this new procedure is less invasive and has added safety benefits to the patient. [1:34] Speaker 1: Using McGinley [1:35] Speaker 1: Augmented reality for Ultrasound Technology, the physician is able to overlay the Ultrasound image on the physical anatomy of the patient. This system provides ergonomic and functional benefits to physicians. They can now be comfortable while looking directly at the anatomy without turning their head away to visualize the Ultrasound image. While working with such minute and. [1:55] Speaker 1: Critical structures such as nerves and arteries, it is critically important [1:59] Speaker 1: for the physicians to be able to visualize [2:01] Speaker 1: their hands and surgical tools by overlaying the [2:04] Speaker 1: Ultrasound image on the physical anatomy. [2:07] Speaker 2: The provider can see in real time where the anatomic structures and instruments are, [2:11] Speaker 1: providing a safer environment for the patient and a more accurate [2:14] Speaker 1: and precise set up for the physician. [2:17] Speaker 1: To begin, the patient is placed in the supine anatomical position, arms extended, palms facing up, using the Augmented reality for Ultrasound Technology. [2:27] Speaker 1: The physician will identify bony and soft tissue landmarks including critical nerve branches, arteries, in the adjacent carpal bones. The lunate bone will be marked as the landmark for skin entry. He will then inject a 1% lidocaine solution into the skin. Following this, a 10 cc mixture of 1% lidocaine and buppivocaine, a combination which provides a longer anesthetic for the patient after the procedure, will be injected along the procedure path using Ultrasound. [2:54] Speaker 1: The physician will then place the needle into the transverse carpal ligament and inject additional numbing solution. [3:01] Speaker 1: The physician then makes a small longitudinal incision about 4 to 5 millimeters long at the marked entry site of the wrist at the level of the proximal wrist fold. A dilator is then inserted using Ultrasound along the expected treatment site in the safe zone. [3:16] Speaker 1: The dilator will free up any adherent tissues to allow ease of insertion of the SX1 micro knife [3:23] Speaker 2: throughout the entire procedure. The adjacent critical structures are visualized and noted. The locations of the median nerve radially and the ulnar artery along the ulnar margin of the arm are again documented. The physician is now able to easily place the SX1 device into the incision and along the safe zone between the median nerve and ulnar artery. [3:44] Speaker 1: Next, the physician inflates the balloons on the [3:46] Speaker 2: SX1, [3:47] Speaker 1: which helps [3:48] Speaker 1: to displace the critical structures and turn a clear zone to observe the transverse carpal ligament under direct visualization. He then deploys the cutting blade, transecting the transverse carpal ligament. This will take 2 to 3 passes if the ligament is thick. Once complete, the physician will place the blade back into the home position of the SX1 and release the balloons. [4:12] Speaker 1: He will remove the device from the wrist and with the dilator [4:15] Speaker 1: and Ultrasound will ensure the transverse carpal ligament [4:18] Speaker 1: is fully released. [4:21] Speaker 1: The incision is then covered with steri-strips. The patient is able to leave the facility shortly [4:26] Speaker 1: after the procedure [4:28] Speaker 1: without need for Pain medications, in sharp contrast to traditional Carpal Tunnel procedure recovery times of 2 to 3 [4:34] Speaker 1: weeks. [4:35] Speaker 2: The [4:36] Speaker 1: expected recovery time for this procedure [4:38] Speaker 1: is approximately 48 hours. Most people are able to [4:41] Speaker 2: Return to work after just [4:43] Speaker 1: 24 hours. [4:44] Speaker 2: Another benefit of the Ultrasound guided Approach is the recovery process. Pictured here is an example of the difference in the post-op [4:51] Speaker 2: incision sites, [4:52] Speaker 1: one showing the site [4:53] Speaker 2: after the traditional [4:54] Speaker 2: Approach and the Other showing the site after the Ultrasound guided procedure. Doctor McGinley is among the first physicians in the country to use an Ultrasound guided microinvasive procedure to correct Carpal Tunnel syndrome. [5:06] Speaker 2: And the very first to do it with the use of Augmented reality, [5:09] Speaker 1: he performs the [5:10] Speaker 1: procedure using the latest [5:11] Speaker 1: innovative technologies, [5:12] Speaker 1: real-time Ultrasound guidance through [5:14] Speaker 1: his [5:14] Speaker 2: AR [5:14] Speaker 1: system, and the Sonic [5:16] Speaker 1: Health SX1 microknife. To see this [5:19] Speaker 1: procedure [5:19] Speaker 2: in [5:19] Speaker 1: action, [5:20] Speaker 2: Doctor Joseph [5:21] Speaker 1: McGinley runs a physician shadowing program. [5:23] Speaker 1: At McGinley Clinic in Casper, Wyoming. For inquiries or [5:27] Speaker 2: more information, please go to [5:29] Speaker 1: www.the McGinleyclinic.com or call [5:33] Speaker 1: 1-866-OtHO-Y [5:35] Speaker 2: or [5:36] Speaker 1: 1-866-678-4699 [5:39] Speaker 2: for more [5:40] Speaker 2: information.