Our benefits are:

1. no skin incision
2. no dressing or scar after the surgery
3. immediate return of patients to their daily activities
4. two patented instruments, one for carpal tunnel syndrome and one for the trigger finger.

Percutaneous surgery using Spirecut Sono-Instruments® is cost-effective, but a high-frequency ultrasound (minimum 15MHz) is necessary with an adapted probe (using a hockey-stick probe is convenient for trigger finger surgery).

Several advantages result in the surgery being cost-effective: 

1. the rapidity of the operation, 
2. the surgeon can operate without an assistant or without a set of surgical instruments that need to be re-sterilized
3. the fast return of the patient to her/his professional activities.

Patients can return to their daily light activities on the next day.

The procedure should be performed under local anaesthesia.

It is possible to operate simultaneously on both hands for bilateral carpal tunnel syndrome, multiple trigger fingers, or a carpal tunnel and a trigger finger. No dressing is required, except on the day of the surgery.

Although there is no skin incision, only a minor puncture, the surgeon cuts the same ligament as for the open/endoscopic surgery. As a result, the operated area will likely cause pain for several weeks (sometimes months) after the surgery. This postoperative symptom is called pillar pain and occurs after all modes of carpal tunnel release. It is related to ligamentous healing, and in some patients, it may preclude heavy manual work for a prolonged duration.

There is no scar resulting from this surgery.

Local anaesthesia is preferred because of decreased morbidity. It allows dynamic perioperative testing (before, during and after the release) of actively movable structures like the flexor tendon(s) in the carpal tunnel and trigger finger/thumb. Moreover, under local anaesthesia, dysesthetic pain during the procedure may alert the clinician to the vicinity of a nerve.

No surgery is without risk. The surgeon must be experienced in hand surgery and sonography and must have followed lab manual-skills training with associated instrumentation before the procedure. The surgeon is advised to review the instructions for use before performing any surgery carefully.

SPIRE is the acronym of Swiss Percutaneous Instruments, allowing Rapid and Efficient Surgery. SPIRE evokes also the similarity of the conical shape of the instruments ; CUT reminds us that the instruments allow the quick and efficient release of thickened pathological tissues like the fingers annual pulleys or the transverse carpal ligament.