Endoscopic Carpal Tunnel Release Surgery

Carpal tunnel syndrome is a painful condition which occurs when the median nerve, which runs from your forearm into the palm of the hand, becomes pinched or squeezed at the wrist. The pain and discomfort typically grows progressively worse with time. Endoscopic carpal tunnel release surgery relieves pain by slightly opening the band of ligament tissue around the wrist to reduce pressure on the nerve.

How is Endoscopic Carpal Tunnel Surgery Performed?

In endoscopic surgery, Dr. Donnelly uses an endoscope—a telescope-like tool with a tiny camera attached to it—to both see inside the wrist and to also perform the surgery through a small incision in the wrist. This less invasive procedure allows Dr. Donnelly to work around tissue rather than cutting through it.

The surgery is typically performed under general or local anesthesia and does not require an overnight hospital stay. During the recovery process, the ligament gradually grows back together, but with more room for the nerve. Endoscopic surgery is often preferred to open carpal tunnel surgery because of the faster recovery and less postoperative discomfort than open release surgery.

Why is Carpal Tunnel Syndrome a Common Problem?

When we look at the anatomy of the wrist, the carpal tunnel is a narrow structure at the base of the palm. The tunnel is formed by the bones of the wrist and a strong band of connective tissue - the transverse carpal ligament. This ligament connects the bones to each other where the wrist and palm meet.

Increased pressure in the tunnel affects the function of the median nerve. This is the nerve which passes under the transverse carpal ligament at the wrist to give sensation to the thumb, index, middle, and inner portion of the ring fingers. The tendons that bend the fingers and thumb, called flexor tendons, also travel through the carpal tunnel. With so much function taking place is a very tight space, a combination of factors can result in Carpal Tunnel Syndrome:

Swelling of the lining of the tendons – tenosynovitis
Acute injuries (fractures/dislocations)
Arthritis
Fluid retention during pregnancy
Diabetes or thyroid gland imbalance
Heredity – anatomically smaller carpal tunnel

When is surgery recommended for Carpal Tunnel Syndrome?

If non-surgical methods of treatment have failed to resolve the tingling, numbness, pain and weakness in the hand, wrist or forearm, endoscopic carpal tunnel release surgery may be necessary. The procedure itself typically takes only 10 to 15 minutes. However, the patient may spend about 45 minutes in the operating room while equipment is set up and anesthesia administered.

What is a Typical Recovery Time?

After surgery, many patients experience quick symptom relief, however in severe cases the numbness and tingling may take several months to resolve. The soreness around the incision may last for several weeks and even a few months, but most people are able to return to their normal activity within a month of surgery. As with all surgical procedures, specific recovery time varies by patient.