Endoscopic Carpal Tunnel Surgery for Carpal Tunnel Syndrome
Endoscopic surgery uses a thin, flexible
tube with a camera attached (endoscope). The endoscope is guided through a
small incision in the wrist (single-portal technique) or at the wrist and palm
(two-portal technique). The endoscope lets the doctor see structures in the
wrist, such as the transverse carpal ligament, without opening the entire area
with a large incision.
The cutting tools used in endoscopic
surgery are very tiny. They, also, are inserted through the small incisions in the
wrist or wrist and palm. In the single-portal technique, one small tube
contains both the camera and a cutting tool.
The small incisions in the palm are closed with stitches. The gap where
the ligament was cut will eventually fill with scar tissue.
have endoscopic carpal tunnel release surgery, you likely will not have to stay
in the hospital. You can go home on the same day.
What To Expect After Surgery
You can expect a shorter recovery
period after an endoscopic surgery than after open surgery, because the
procedure does not require cutting the palm open and disturbing a large area of
The pain and numbness may go away right after surgery,
or it may take several months. Try to avoid heavy use of your hand for a couple
How soon you can return to work depends on whether your
dominant hand (the hand used most, such as the right hand if you are
right-handed) was involved, on your work activities, and on the effort that you
put into rehabilitative physical therapy.
If you have surgery on your nondominant hand
and don't do repetitive, high-risk activities at work, you may be able to
return to work within 1 to 2 days.
If you have surgery on your
dominant hand and do repetitive activities at work, you may require 4 or more
weeks for recovery. Physical therapy may speed recovery.
Why It Is Done
Endoscopic carpal tunnel release
surgery is considered when:
You still have symptoms after a long period of
nonsurgical treatment. In general, surgery is not considered until after several weeks to months of nonsurgical treatment. But this assumes that you are having
ongoing symptoms but no sign of nerve damage. Nerve damage would make surgery
Severe symptoms (such as persistent loss of feeling or
coordination in the fingers or hand, or no strength in the thumb) restrict your
normal daily activities.
There is damage to the median nerve
(shown by nerve test results and loss of hand or finger function) or a risk of
damage to the nerve.
A person who is having surgery on both wrists, or who
depends on a wheelchair, a walker, or crutches, may choose endoscopic surgery
because the healing time can be shorter than with open surgery.
How Well It Works
Most people who have surgery for
carpal tunnel syndrome have fewer or no symptoms of pain and numbness in their
hand after surgery.1
In rare cases, the
symptoms of pain and numbness may return (the most common complication), or
there may be temporary loss of strength when pinching or gripping an
If the thumb muscles have been severely weakened or wasted
away, hand strength and function may be limited even after surgery.
The risk and complication rates for endoscopic
surgery are very low. Major problems such as nerve damage happen in fewer than
1 out of 100 surgeries (less than 1%).2
Possible problems from endoscopic carpal release surgery include injury
to nerves, blood vessels, and tendons. There are also the risks of any type of
surgery, including possible infection and
risks of general anesthesia. But most endoscopic
carpal tunnel surgery is done with
local anesthesia or regional block rather than with
What To Think About
If you are going to have an
endoscopic carpal tunnel release, look for a surgeon who has experience doing
endoscopic surgery. Ask how successful he or she has been with people who had
conditions similar to yours.
Both endoscopic and open carpal
tunnel release have benefits and risks. Studies do not show that one procedure
is better than the other.2 Talk to your doctor about
How this information was developed to help you make better health decisions.