I made incision approximately 1.5 thumb lengths posterior to the medial tiba crest, from the inferior border of the medial head of the gastroc extending approximately 5cm proximally. Dissect through the subcutaneous and deep fascia then use fingers to separate gastroc from soleus. Retract, have headlight, use long knife handle with 15 blade and cut anterior fascial covering of gastroc (sharp edge of blade faces posteriorly) all the way across. Again, the concern with this is to avoid the sural. Did one last week that went well, but never visualized the sural.