Yumoto Orthopaedic Clinic (JP HOME) is the Originator of
  Percutaneous Trigger Finger Release Surgery with Guided Knife		 Since
2011/07/31		  
Ultrasound Apparatus
- Ultrasound is indespensable for GK-PTFR Surgery -
We use the latest version of Ultrasound apparatus .
LOGIC E10 of GE Healthcare is the latest Ultrasound in this clinic, replacing HI Vision Preirus of HITACHI..

Ultrasound has made GK-PTFR safer and more secure

* GK-PTFR can be done WITHOUT Ultrasound apparatus
Before introduction of Ultrasound, GK-PTFR had been a kind of Handicrft. Surgeon had to be thoroughly aquainted with hand anatomy, as well as palmar skin function or characteristics
There are two types of Guided Knife, one with sharp edge and one with blunt edge.

The right photo is the former Ultrasound apparatus.

GK-PTFR has been categorized into the following three to match the description of videos in VideoLibrary, according to whether preliminary Blunt knife probing with or without Ultrasound observation had been performed or not.

[Category 1]
Bring in Blunt knife first, insert its guide section underneath A1 pulley. After successful LURT (see the following article) with the knife, it could be replaced with Sharp knife to proceed release operation.
  • Although correct insertion of guide section beneath A1 pulley is essential for success of operation, it could not always be achieved in the first trial.
  • Repeated trials of guide insertion with Blunt knife would not bring forth crucial damage to the tendon or other soft tissues, but with Sharp one.
  • When you are confident that guide section is in the right place, replace Blunt knife with Sharp one to proceed . To make this transition easy, shapes of both knives are identical.
[Category 2]
Ultrasound device adds objective proof at LURT that guide section is correctly set beneath A1 pulley, and is recommended especially for h surgeons who are new to GK-PTFR.

* Upper picture: Ultrasound apparatus that I used at operations included in VideoLibrary.
* Lower picture: Waterproof probe very suitable for this purpose.
  • Ultrasound observation of guide section beneath A1 pulley gives definite proof that the operation is on track.
  • I have introduced HI VISION Preirus by HITACHI for intraoperative ultrasound observation since October 2010.
    The purpose of the Ultrasound is both practical and educational for me.
    The probe EUP-O54J is very suitable for this purpose, by its high resolution and by its shape easy to handle.
    This probe is made water resistant to facilitate soaked sterilization.
  • Eighteen videos under this category are included in VideoLibrary.
[Category 3]
Operation is done with Sharp knife alone without help of Blunt knife or Ultrasound.
  • Although I have operated most of the cases in VideoLibrary this way, I never forgot to prepare Blunt knife for cases when I failed the first LURT with Sharp knife. In such cases, I had changed procedure at once which falls into Category 1.
  • Only in cases when distal margin of A1 pulley could be felt clear enough at preoperative palpation, this might be the choice.
  • This operation technique is recommended only for advanced hand specialists well accustomed with the use of Guided Knife.
For more information, refer to related articles of this homepage.