Nanoscope-assisted release of the lacertus fibrosus: A cadaveric study of feasibility, visualization, and anatomical safety

Table 1 Standardized NanoScope-assisted lacertus fibrosus release protocol

Step	Description
1	Positioning of the specimen in supine position with the elbow slightly extended and the forearm in full supination
2	Identification and marking of surface landmarks, including the antecubital crease and distal biceps tendon
3	Creation of a 1-cm transverse skin incision 2-3 cm distal to the antecubital crease
4	Blunt dissection to the deep fascia to establish a limited working corridor
5	Introduction of the 19-mm 0° nanoscope through the nanoneedle portal
6	Nanoscopic identification of the lacertus fibrosus
7	Visualization of the median nerve and adjacent brachial artery
8	Introduction of the cutting device superficial to the median nerve under direct visualization
9	Controlled division of the lacertus fibrosus in a radial-to-ulnar direction
10	Nanoscopic confirmation of completion of the release

Table 2 Visualization quality scores and interobserver agreement

Structure evaluated	Visualization score, mean ± SD
Median nerve	4.8 ± 0.3
Lacertus fibrosus	4.9 ± 0.1
Brachial artery	4.6 ± 0.4