MINIMALLY INVASIVE PERIPHERAL NERVE SURGERY: A SHORT SCAR TECHNIQUE

Introduction. As peripheral nerve specialists can have a wide variety of training backgrounds, few standards of care exist with respect to necessary incision length, amount of dissection, and operative technique for common nerve decompressions. Methods. Approaches for the following 12 common peripheral nerve surgeries were minimized using shorter incisions and a simple lighted retractor: zygomatico-temporal and auriculotemporal, greater occipital, brachial plexus, ulnar, radial, median, lateral femoral cutaneous nerve of the thigh, peroneal at the groin, fibular neck and lateral calf, and tibial and inner ankle. The new 'minimal' incision length was recorded as was that of the 'classical' approach as taught to the senior author and frequently represented in atlases. A Mann-Whiney analysis was independently performed to evaluate for significance between the lengths of incisions for each procedure. Results. The average length of the 'minimal' incisions was 3.9 +/- 0.6 cm (range, 3.1-6.1 cm), with an average reduction in length of 51% as compared with the 'classical' incisions (range, 30-75%; P < 0.001). There were no perioperative morbidities. Conclusions. Minimally invasive peripheral nerve surgery applied to the above procedures yields successful surgical outcomes while shortening incision lengths and maximizing patient satisfaction without sacrificing patient safety. (C) 2010 Wiley-Liss, Inc. Microsurgery 30:622-626, 2010.