What is Endoscopic Carpal Tunnel Release?
Carpal tunnel syndrome occurs when the median nerve is compressed while traveling through the carpal tunnel, a narrow passageway made of bones and ligaments in the wrist. The carpal tunnel is intended to provide protection for the median nerve and tendons that pass through it. The median nerve is responsible for movement and sensation for parts of the hand, so irritation from compression can cause pain, numbness and tingling in the hand and wrist.
Endoscopic carpal tunnel release is a procedure used to help treat pain and sensation loss from carpal tunnel syndrome by relieving pressure on the median nerve. This is accomplished by cutting the transverse carpal ligament, the ligament on top of the carpal tunnel, enlarging the carpal tunnel.
Who needs Endoscopic Carpal Tunnel Release?
Symptoms of carpal tunnel syndrome include numbness and tingling on the palm side of the hand, fingers, and thumb. Pain or a burning sensation in the forearm, wrist, or hand that increases with activity may also be present. Weakness may also occur, as over time the muscles around the thumb will shrink and lose strength, resulting in trouble forming a fist or grasping objects.
Carpal tunnel is conservatively treated at first with treatments like rest, changes in patterns of use, immobilizing the affected area with devices like splints or braces, physical therapy, medication and injections. If the symptoms do not improve after some time using conservative treatments, or if nerve damage or muscle weakness is occurring, your doctor may suggest this procedure.
What are the steps in Endoscopic Carpal Tunnel Release?
A small incision is made on the patient's affected wrist. The surgeon may also create a second incision in the palm.
Insertion of Guide
The surgeon then inserts a hollow, semicircular device called a guide through the incision, placing it between the transverse carpal ligament and the median nerve. The median nerve is protected by the guide during the procedure.
Insertion of Endoscope
A small, lighted camera called an endoscope is inserted into the guide. The surgeon uses the endoscope to view the inside of the hand and wrist via the images the endoscope sends.
Cutting the Ligament
The surgeon then inserts a cutting tool into the guide. With the endoscope for image guidance, the transverse carpal ligament is cut to alleviate the stress on the median nerve.
End of Procedure
All instruments are then removed, and the incisions are closed.
This procedure is usually performed on an outpatient basis, so most patients are able to leave the hospital the day of the procedure. To keep movement minimal during the recovery process, a splint may be worn on the wrist while the ligament and median nerve heal.
Because endoscopic carpal tunnel release is a minimally invasive procedure, the recovery process may be quicker, less painful, and with less scarring than traditional surgery. However, adherence to physical therapy exercises, specifically hand rehabilitation therapy, should be used during recovery to ensure strength is restored to the hand and wrist.