Endoscopic carpal tunnel release uses an endoscope, an instrument attached to a video monitor to visualize the undersurface of the transverse carpal ligament. This avoids the need to make an incision in the palm. Instead the surgeon makes the incision in the wrist crease near the base of the palm.
The surgeon esssentially releases the ligament from the inside out, avoiding damaging the tough tissues called fascia in the palm that give the palm its shape and contour. In addition the plam skin incision is avoided. For many this reduces the immediate problem of using the hand more fully in the early post operative period. It does not mean that there will be absolutely no discomfort but many feel it is less. Typically however one must realize that there are many people who undergo so called regular open carpal tunnel release who have very little pain and many do not need to take pain medicine at all. However those who have endoscopic release who do well, do well a little bit sooner.
The greatest potential benefit is for those patients who need to get back to a job or activity that requires a lot of palm contact. Somethinig that we refer to as a "palm-intensive" activity.
While 5-6 weeks down the line most patients with either an open or endoscopic release are at nearly the same place with respect to activities, the endoscopically released hands seem to be more comfortable sooner.
Must my carpal tunnel be released endoscopically?
No. It is important to understand that this is one method that for some people can be beneficial. Standard carpal tunnel release is a tried and true method and typically has very good results.
IS Endoscopic Carpal Tunnel... LASER SURGERY?
No. The term laser surgery is a misnomer. In other words, some people call endoscopic or arthroscopic surgery laser surgery for some reason but there is no laser involved. While lasers are used by surgeons for a variety of conditions there is no role for laser here. Despite this, that question gets asked often by a lot of people who have heard about someone getting laser surgery for their carpal tunnel.
What should I do if I want to have this method used?
There are several different ways of doing an endoscopic carpal tunnel release in terms of instruments and the type pf endoscope used. You should make sure your surgeon has experience in their chosen method and instrumentation.
Where is the surgery done?
Like regular open carpal tunnel release endoscopic carpal tunnel release is done typically in an outpatient surgery center setting. The Hand Center of Western Massachusetts is located directly above the Pioneer Valley Surgical Center and Dr. Wint does many of the endoscopic carpal tunnel releases there.
For more information, it is vital to speak to a physician who can discuss with you with regard to whether you might be a candidate for this procedure and what the risks and benefits are. This page is for introduction of this topic and should not be used as a sole source of information.
For additional information: PLEASE NOTE THAT SOME OF THE INFORMATION ON THESE LINKS MAY HAVE A COMMERCIAL BIAS
Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release A Prospective, Randomized Trial
Baystate Health Systems Article from 2001
American Academy of Orthopedic Surgeons Bulletin 1997
Instrumentation used by Dr. Wint in endoscopic carpal tunnel release
Jeffrey C. Wint, M.D.
THE HAND CENTER OF WESTERN MASSACHUSETTS
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