This endoscopic clinical photograph provides an intraoperative view of a carpal tunnel release procedure. The image depicts the surgical field after the successful division of the flexor retinaculum (transverse carpal ligament). Centrally located is the median nerve, which appears as a light yellow, elongated structure with a smooth surface texture. A prominent, brighter yellowish-white fat pad is visible overlying the distal portion of the nerve, serving as a critical anatomical landmark for confirming complete ligamentous release. The surrounding surgical field shows reddish-pink soft tissue and muscular layers, indicating local vascularity. The image demonstrates the specialized supraretinacular endoscopic approach, allowing for direct visualization and decompression of the median nerve within the carpal tunnel while minimizing trauma to superficial structures. This visual is intended for orthopedic and neurosurgical education regarding the anatomy of the wrist and endoscopic surgical techniques for carpal tunnel syndrome.

This composite clinical and diagnostic image illustrates Endoscopic Carpal Tunnel Release (ECTR) for the treatment of carpal tunnel syndrome. Image A is a clinical photograph showing the surgical setup: a patient's hand is positioned supine on a sterile blue drape with surgical markings indicating Kaplan's cardinal line. A small proximal wrist incision is visible, through which an endoscopic cannula and obturator assembly are inserted into the carpal canal. A surgeon's gloved hands are shown stabilizing the instrument. Image B provides the corresponding intraoperative endoscopic view from a 4-mm rigid scope. It depicts the pale, fibrous internal surface of the transverse carpal ligament (TCL) with a clear longitudinal division or cut, demonstrating the release of the ligament to decompress the median nerve. This content is intended for orthopedic and neurosurgical education, highlighting the minimally invasive endoscopic approach versus open carpal tunnel release.

A composite image illustrating a minimally invasive endoscopic carpal tunnel release (ECTR) procedure. The left panel shows the external surgical setup: a patient's hand is positioned on a metallic hand table with blue sterile draping. A small transverse incision is visible at the proximal wrist crease, through which an endoscope and a specialized blade assembly are inserted. A surgeon's gloved hand is seen manipulating the instrumentation. The right panel displays the concurrent internal endoscopic view (endoview) within the carpal tunnel. The image highlights the dense, white, fibrous transverse carpal ligament (flexor retinaculum) and the positioning of the metallic blade and scope sheath underneath it. This visual demonstrates the surgical technique used to transect the ligament and decompress the median nerve, typically indicated for severe carpal tunnel syndrome. The procedure is categorized under orthopedic or hand surgery, focusing on compressive neuropathy management.

A composite image demonstrating biportal endoscopic carpal tunnel release (ECTR). The left side is a clinical photograph showing the surgical setup on a supinated human hand. Two portals are visible: a proximal port at the distal wrist crease and a distal port in the palm. An endoscope is inserted into the proximal portal, while a metallic surgical dissector is introduced through the distal portal, illustrating the 'two-portal' or Brown technique. The right side displays the corresponding internal endoscopic view of the carpal tunnel. The image shows the bright, white, fibrous bands of the transverse carpal ligament (TCL) and a metallic retrograde blade or dissector engaged with the tissue for transection. This visual captures the minimally invasive approach used to decompress the median nerve while minimizing surgical trauma to the palmar fascia and skin. The educational focus is on the instrumentation, portal placement, and internal visualization required for safe ligament release.