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Carpal Ligament System


Developed with Dr. James C.Y. Chow, the Smith & Nephew ECTRA II Carpal Ligament System allows endoscopic access and release of the carpal ligament with complete visualization control. ECTRA knives permit the surgeon to determine both the direction and depth of cut. The key to the system is ECTRA's slotted cannula. It permits access to the ligament via two portals, which allows cutting from either the distal or proximal end while minimizing endoscopic lens fogging with good airflow. ECTRA II can also be used in the release of the plantar fascia ligament.

Precision instruments in a convenient, disposable kit

Probe knife Patented design permits release of the distal aspect of the ligament while protecting palmar neurovascular structures. This is achieved by the forward cutting action that allows the surgeon to cut proximally. The knife's blunt top and proximal edge allow palpation to dissect synovium and precisely locate the ligament's edge.
Triangle knife Allows the controlled upward cut, creating a central opening to insert the retrograde knife. This exacting tool may also be used for follow-up cuts if needed, dissecting one fiber at a time under visualization.
Retrograde knife Effectively cuts the ligament without damaging the palmaris brevis. Unique design with polished leading tip and upper curve glides between ligament and muscle while feeding the ligament into the cutting edge of the knife's lower curve.
Hand pad Cushions the back of the hand for the patient's comfort.
Swabs Allow surgeon to eliminate condensation without removing endoscope.
EctraIICarpalLigamentSystem_Overview_Swabs1 EctraIICarpalLigamentSystem_Overview_Swabs2 EctraIICarpalLigamentSystem_Overview_Swabs3
The probe knife is shown inserted through the distal portal, cutting the distal edge of the carpal ligament, distal-to-proximal The triangle knife allows a controlled upward cut for incising the midsection of the carpal ligament The retrograde knife is shown cutting distally to join the previous two incisions, completing the release of the distal carpal ligament.
EctraIICarpalLigamentSystem_Overview_ProbeKnife EctraIICarpalLigamentSystem_Overview_TriangleKnife EctraIICarpalLigamentSystem_Overview_RetrogradeKnife
Probe Knife Triangle Knife Retrograde Knife

ECTRA II System allows endoscopic carpal tunnel access

Palmar arch suppressor Serves to depress and protect the palmar arch and receive the obturator tip as it exits the second portal.
VideoEndoscope Prevents light guide from interfering with the forearm by providing a light post on the same side as the direction of view. This endoscope is available in an eyepiece or 35 mm video format.
Slotted cannula Permits endoscopic surgery via two portals
Detachable handle Attaches to the obturators, each mating perfectly with the slotted cannula for smooth insertion into the carpal tunnel - dissecting, boat nose and conical.
Dissecting obturator Agressively clears the underside of the carpal ligament.
Boat nose obturator Provides minimal dissection and easy distal exit.
Conical obturator Promotes easy distal exit.
Hand holder Maintains hand in proper hyperextended position to open tunnel. Snaps on to tray for convenient system storage.
Probe Palpates the transverse carpal ligament.
Blunt curved dissector Assists surgeon in identifying/clearing proximal edge of the transverse carpal ligament
Ragnell retractors (2) Provide surgeon with control to hold entry portal open prior to cannula placement.


Ordering Information

Disposable Procedure Kit
4116 ECTRA II Procedure Kit, single-use, disposable
Contents: Probe knife, retrograde knife, triangle knife, hand pad, swabs
4447 Probe knife (box of 6)
4448 Triangle knife (box of 6)
4449 Retrograde knife (box of 6)

ECTRA II System and individual components
4143 ECTRA II System (35 mm VideoEndoscope)
4149 ECTRA II System (direct view)
3896 VideoEndoscope, 35 mm
4144 Direct view endoscope
4120 Slotted cannula
4432 Detachable obturator handle
4433 Conical obturator
4434 Boat nose obturator
4435 Dissecting obturator
4101 Blunt dissector, curved
4452 Ragnell retractor (2 included with the system)
3856 Probe EctraIICarpalLigamentSystem_Ordering_Components
4283 Palmar arch suppressor
4450 Hand holder/sterilization tray with cover
4141 Hand strap
4453 ECTRA II Obturator Set
4432 Detachable obturator handle
4433 Conical obturator
4434 Boat nose obturator
4435 Dissecting obturator
1030040 Illustrated guide to endoscopic release of the carpal ligament
4124 Videotape:
ECTRA II, the Modified Chow Technique

ECTRA II Downloads

ECTRA II Brochure

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This information is intended for health care professionals in the United States only.

Caution: US Federal law restricts the sale of these devices to or on the order of a physician.