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Les points d’introduction distaux sont à peu près symétriques à 2,5 cm de la pointe malléolaire, après infiltration du tissu sous cutané au sérum physiologique. Elle ne présente guère de difficultés techniques, à la condition que l’abord de la gaine se fasse sous contrôle de la vue. Après dilatation de la gaine, un optique de 4 mm peut ensuite être remonté en proximal. Un point d’introduction proximal est repéré par trans luminescence, permettant une vision descendante en changeant l’optique, et l’introduction d’un crochet palpeur ou d’une instrumentation motorisée.
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