Carpal Tunnel Syndrome (CTS) is a common condition that affects millions of people worldwide. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This compression leads to symptoms such as numbness, tingling, weakness, and pain in the hand and fingers. When conservative treatments fail to relieve symptoms, surgical intervention may be necessary. One of the most advanced and minimally invasive surgical options available today is Endoscopic Carpal Tunnel Release Surgery.
The carpal tunnel is a narrow passageway located on the palm side of the wrist. It is bounded by bones and ligaments and contains the median nerve along with tendons that control finger movement. When the tissues surrounding the tendons become swollen or thickened, they can compress the median nerve, leading to CTS.
When non-surgical treatments such as wrist splinting, anti-inflammatory medications, and corticosteroid injections do not provide relief, surgery may be recommended to relieve pressure on the median nerve.
The traditional surgical approach involves making a 2 to 3-inch incision in the palm of the hand to directly visualize and cut the transverse carpal ligament, which forms the roof of the carpal tunnel. This procedure effectively relieves pressure on the median nerve but may involve a longer recovery time, more postoperative pain, and a visible scar.
Endoscopic Carpal Tunnel Release (ECTR) is a minimally invasive technique that uses a small camera (endoscope) and specialized instruments to perform the surgery through one or two small incisions, typically less than an inch in length. The surgeon inserts the endoscope into the carpal tunnel to visualize the transverse carpal ligament and then carefully cuts it to relieve pressure on the median nerve.
Smaller Incisions and Less Scarring
The small incisions used in endoscopic surgery result in minimal scarring compared to the larger incision in open surgery. This is particularly beneficial for patients concerned about cosmetic outcomes.
Reduced Postoperative Pain
Because the surgery is less invasive and causes less disruption to the surrounding tissues, patients often experience less pain after the procedure.
Faster Recovery and Return to Activities
Many patients undergoing endoscopic release can return to normal activities, including work, more quickly than those who have open surgery. This is especially important for individuals whose jobs require repetitive hand movements.
Improved Visualization
The endoscope provides a magnified view of the carpal tunnel structures, allowing the surgeon to perform the release with precision and minimize the risk of injury to nerves and blood vessels.
Before surgery, the surgeon will conduct a thorough evaluation, including a physical examination and possibly nerve conduction studies or electromyography (EMG) to confirm the diagnosis and assess the severity of nerve compression.
ECTR is typically performed under local anesthesia with sedation or regional anesthesia (nerve block), allowing the patient to remain comfortable and pain-free during the procedure.
The procedure usually takes about 15 to 30 minutes and is often performed on an outpatient basis, allowing patients to go home the same day.
Mild pain or discomfort is common and can be managed with over-the-counter pain relievers or prescribed medications.
Some patients may benefit from hand therapy exercises to restore strength and flexibility. Your surgeon or therapist will guide you on appropriate exercises.
Most patients can resume light activities within a few days and return to work within 1 to 3 weeks, depending on the nature of their job. Full recovery and return to strenuous activities may take 4 to 6 weeks.
While endoscopic carpal tunnel release is generally safe, as with any surgery, there are potential risks, including:
Choosing an experienced surgeon and following postoperative instructions carefully can minimize these risks.
ECTR is suitable for patients with moderate to severe carpal tunnel syndrome who have not responded to conservative treatments. It is especially beneficial for those who prefer a quicker recovery and minimal scarring. However, certain conditions such as previous wrist surgery, severe anatomical abnormalities, or extensive scar tissue may make open surgery a better option.
Endoscopic Carpal Tunnel Release Surgery represents a significant advancement in the treatment of carpal tunnel syndrome. By offering a minimally invasive approach with smaller incisions, less pain, and faster recovery, it has become a preferred option for many patients and surgeons alike. If you are experiencing symptoms of carpal tunnel syndrome that interfere with your daily life, consult a qualified hand specialist to discuss whether endoscopic carpal tunnel release surgery is right for you.