[2] Under the real-time guidance of ultrasound, a spinal needle is inserted at the palm of the hand and advanced underneath the transverse carpal ligament (TCL) and exiting at the wrist.

The frictional division of soft tissue concentrates the shear forces into the targeted tissue, resulting in significantly less collateral damage to adjacent anatomic structures than can be caused by the plowing and cutting of abrasive dividing.

[4] Thread can be used to divide soft tissue in minimally invasive surgeries due to its unique properties: The flexibility of thread allows it to be routed along a designated path to form a loop around the targeted tissue that precisely controls the division.

Precise looping or routing is essential to the safe and effective use of a dividing thread.

Through the technique of TCTR, the possible postoperative complications, such as pillar pain, scar tenderness, or functional weakness, may be minimized significantly by avoiding the unnecessary injuries and disturbers to the surrounding of TCL during the procedure of decompressing the median nerve.