Endoscopic Carpal Tunnel Release

In your hand, the median nerve runs through a narrow space between your carpal bones and underneath a thick ligament in the palm of your hand. When the narrow passageway becomes inflamed, injured, or tight, tissues can swell. This irritates the median nerve, resulting in frustrating symptoms such as numbness and tingling. You may also have pain, weakness, and difficulty with movement with carpal tunnel syndrome. The purpose of an endoscopic carpal tunnel release is to relieve pressure on your median nerve with a minimally invasive surgical procedure.

How an Endoscopic Carpal Tunnel Release is Performed

In an endoscopic carpal tunnel release, the surgeon makes one or two small incisions into your wrist or the palm of your hand. One of these portals is used to insert a small fiber-optic camera. The images captured by the camera are shown on a screen. The surgeon uses those images to guide the surgical instruments through the other opening.

To release the carpal tunnel, the doctor divides and cuts through the transverse carpal ligament that is compressing the tunnel. Doing this makes more room for the median nerve and the nine tendons that traverse the tunnel. Once the instruments are removed, a few stitches are placed into the hand. This procedure is done on an outpatient basis and with local anesthesia. Most patients find an immediate improvement in symptoms and functioning of their hands.

Candidates for Endoscopic Carpal Tunnel Release

You may need to have an endoscopic carpal tunnel release if you have carpal tunnel syndrome. In most cases, the surgery is performed after you have tried other methods of controlling the pain, numbness, and tingling. The non-surgical methods recommended for relieving carpal tunnel symptoms include wearing a wrist and thumb brace, performing stretching exercises of the hands, reducing repetitive motions, and using non-steroidal anti-inflammatory medications.
A corticosteroid injection may also be used to reduce inflammation in the carpal tunnel. When those interventions are unsuccessful or significant nerve and muscle damage are present in the wrist or hand, an endoscopic carpal tunnel release may be the best way to eliminate symptoms and restore full functioning to your hand and wrist.

What to Expect After an Endoscopic Carpal Tunnel Release

Immediately after an endoscopic carpal tunnel release procedure, you will be asked to keep your hand elevated. You will wear a wrist brace or splint for two to three weeks. This helps to reduce unnecessary movement of your hand. The compression delivered by the brace also minimizes swelling. Within a day or two of surgery, you can usually return to light activities with your hand, such as buttoning a shirt, pulling a zipper, or holding a fork and spoon. After a few weeks, you will be able to do more, such as sewing and knitting. Full recovery time varies based on the amount of nerve damage, but most patients report that their symptoms are gone within three to six months of surgery.