Endoscopic Carpal Tunnel Release Surgery

What is Endoscopic Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area.

Symptoms of Carpal Tunnel Syndrome

Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except the little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength.

Conservative Treatment Options for Carpal Tunnel Syndrome

Carpel tunnel can be treated with conservative measures or surgical intervention. Conservative treatment options may include treating any underlying medical conditions, such as diabetes and arthritis.  Your hand and wrist may be immobilised with a splint or wrist brace for 4 to 6 weeks. Ice packs may be recommended to keep down any swelling. You may be advised to avoid activities that tend to bring on the symptoms. Medication and steroid injections may be used to treat pain and swelling. You may be referred to therapy to be taught strengthening and stretching exercises.

When conservative treatment options are not effective, surgery may be recommended.

Endoscopic Carpal Tunnel Release Surgery

The surgery is performed by administering local anaesthetic into the wrist and palm of your hand. You will be awake and may feel pressure, but will not feel any pain during the procedure.

A single incision is made in the wrist. Sometimes, your surgeon may make two incisions – one on the wrist and the other on the palm. A tube with a slot on the side called a cannula is inserted through the incision and placed next to the median nerve, just under the offending transverse ligament. An endoscope, a thin, flexible tube with a camera attached is passed through the cannula to look at the carpal ligament from below. The images from the endoscope are visible to the surgeon on the video monitor in the operating room. Your surgeon ensures that the nerves and arteries are not in the way while cutting the ligament. A special cutting tool with a hook is inserted into the cannula. As the tool is pulled back out of the cannula, it cuts the carpal ligament and releases the pressure over the median nerve. The cut ends of the ligament eventually fill in with scar tissue. The skin incision is closed with dissolvable stitches and a dressing is placed. The arm may be put in a sling to provide extra support and reduce swelling.

The procedure usually takes about 20 minutes to complete.

Postoperative Care Endoscopic Carpal Tunnel Release

Your surgeon may suggest you practice certain postoperative procedures for better recovery and to avoid further complications.

  • Elevate the hand above heart level to reduce swelling.
  • A splint may be worn
  • Ice packs to the surgical area to reduce swelling.
  • Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
  • Physical therapy may be ordered to restore wrist strength.
  • Eating a healthy diet and not smoking will promote healing

Risks and Complications of Endoscopic Carpal Tunnel Release Surgery

Most patients suffer no complications following carpal tunnel release surgery. However, some patients may suffer from pain, infections, scarring, and nerve damage causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.