Uniportal access for surgical simplicity
Saves valuable OR time by eliminating patient repositioning
Scope-mounted blade ensures excellent visualization
There are advantages to the Endoscopic Gastrocnemius Release (EGR). They include smaller
incision(s) with less loss of function in the early postoperative period and the ability to regain
propulsion. Concerns with endoscopic surgical techniques include potential complications
(such as neurovascular injury), as well as a learning curve.
Positioning the Patient
The heel may be placed on a sterile bulky towel roll if the patient is supine. This allows the
instruments to pass freely. The surgeon must take care, however, not to allow the knee to be in
recurvatum when assessing ankle dorsiflexion. Alternatively, as an isolated procedure, the EGR
may be performed with the patient in the prone position.
General anesthesia is preferred.
Creating the Pathway
Using the Fascial Elevator, bluntly dissect down to the fascia. Separate the subcutaneous tissue
(which contains the neurovascular structures including the greater saphenous vein, medial
sural cutaneous, sural, and saphenous nerves) from the gastrocnemius fascia.
Remove the Fascial Elevator and introduce the Cannula/Obturator assembly into the same
pathway. Remove the Obturator from the Cannula and insert a 4 mm, 30° endoscope. The
neurovascular structures are completely protected in this manner