Endoscopic Carpal Tunnel Release

Endoscopic carpal tunnel release uses a small camera, called an endoscope, to allow the surgeon to see inside the carpal tunnel. Through a small incision, specialised instruments are used to divide the transverse carpal ligament and release pressure on the median nerve.

Unlike traditional open carpal tunnel release, which involves an incision in the palm, endoscopic surgery uses a smaller incision away from the main weight-bearing area of the palm.

The aim of both techniques is the same: to decompress the median nerve and relieve the symptoms caused by carpal tunnel syndrome.

Not everyone with carpal tunnel syndrome requires surgery. Treatment depends on the severity and duration of symptoms, examination findings and the effect the condition is having on your daily activities.

Non-surgical treatments may be appropriate for mild or intermittent symptoms and can include:

• Wrist splinting, particularly at night
• Activity modification
• Corticosteroid injection in selected cases
• Monitoring of symptoms and nerve function

Surgery may be recommended when symptoms persist despite non-surgical treatment, or when there is significant nerve compression, persistent numbness, weakness or wasting of the muscles at the base of the thumb.

Dr Bissell will assess your symptoms and hand function before recommending whether surgery is appropriate for you.

Research consistently supports several advantages of the endoscopic approach:

• Postoperative pain: Significantly less pain in early recovery
• Grip strength: Better grip strength
• Return to work: Shorter time to return to work
• Scar pain: Lower rates of scar pain

Most patients can return home after carpal tunnel release, depending on the type of anaesthesia and their individual circumstances.

After surgery, your hand will usually be placed in a soft dressing. Keeping the hand elevated can help reduce swelling, particularly during the first 24 hours.

You will generally be encouraged to move the fingers and other unaffected joints soon after surgery. Heavy lifting and strenuous use of the hand should be avoided initially, with activity gradually increased as healing progresses.

Dr Bissell will provide individualised advice about wound care, hand use, driving, work and return to normal activities. Hand therapy may be recommended in some circumstances.

As with any surgery, carpal tunnel release has potential risks and complications. These may include:

• Infection
• Bleeding or bruising
• Persistent or recurrent symptoms
• Tenderness or pain in the palm
• Injury to the median nerve or its branches
• Temporary or, rarely, persistent nerve symptoms
• Incomplete release of the carpal tunnel
• The need for further surgery

Your individual risks will depend on your health, the severity of your carpal tunnel syndrome and other factors. Dr Bissell will discuss the expected benefits, risks and alternatives with you before surgery.

The purpose of surgery is to relieve pressure on the median nerve. Many patients experience improvement in numbness, tingling and other symptoms after carpal tunnel release. Recovery can depend on how long the nerve has been compressed and the severity of the condition. Long-standing or severe nerve compression may take longer to recover and some nerve damage may not be reversible.