Evolution of Technology

Endoscopic Carpal Tunnel Release

Endoscopic carpal tunnel release uses one or two small incisions near the wrist through which instruments are inserted. A small camera is used to visualize the inner wrist, specifically the transverse carpal ligament (roof of the carpal tunnel). Often the camera is attached to an instrument that contains a small cutting tool which is used to divide the transverse carpal ligament while the surgeon visualizes it on the monitor. This releases pressure off the median nerve. The small incision is then closed with stitches.

Evolution of Procedure

Carpal Tunnel Release

Treatment for carpal tunnel syndrome include nonsurgical and surgical options. Nonsurgical treatment options usually begin with behavioral modifications such as limiting activities that aggravate your symptoms. A splint can also be worn to keep your wrist straight. Oral anti-inflammatory medications and/or steroid injections are additional options as well. This treatment can be effective especially if started early (within a few months after symptoms first start). If symptoms persist beyond this, then surgery may be recommended to relieve the pressure off the nerve in the carpal tunnel.

Carpal tunnel surgery is a very common operation. Traditionally, surgery was done via an open technique, meaning the surgeon would make an incision in the skin across your palm and wrist. This provides a view of the transverse carpal ligament and other tissues. The surgeon then cuts the ligament, which relieves the pressure and constriction in the carpal tunnel, allowing normal nerve function to return.

Open surgery leaves a bigger scar and may require a longer recovery. A newer alternative to this technique is performing the surgery endoscopically, meaning making one or two small incision near the wrist and using a small camera to visualize the inside of your wrist on a monitor. The transverse carpal ligament is then cut from underneath. Due to the small incision, endoscopic carpal tunnel release has the advantage of a smaller incision, shorter recovery time and less post-operative pain.