Endoscopic carpal tunnel release

Endoscopic Carpal Tunnel Release

Endoscopic carpal tunnel release (ECTR) is a minimally invasive surgical procedure used to treat carpal tunnel syndrome (CTS), a condition caused by compression of the median nerve as it travels through the carpal tunnel in the wrist. This procedure aims to relieve pressure on the median nerve by cutting the transverse carpal ligament, which forms the roof of the carpal tunnel.

Indications

ECTR is indicated for patients with moderate to severe carpal tunnel syndrome who have not responded to conservative treatments such as wrist splinting, corticosteroid injections, or physical therapy. Symptoms of CTS include numbness, tingling, and pain in the hand and fingers, particularly the thumb, index, and middle fingers.

Procedure

The endoscopic carpal tunnel release is performed under local or regional anesthesia. The surgeon makes one or two small incisions in the wrist and palm. An endoscope, a thin tube with a camera and light, is inserted through one of the incisions to provide a view of the carpal tunnel on a monitor. Using specialized instruments, the surgeon cuts the transverse carpal ligament to relieve pressure on the median nerve.

Advantages

ECTR offers several advantages over traditional open carpal tunnel release, including:

• Smaller incisions, resulting in less scarring.
• Reduced postoperative pain.
• Faster recovery and return to normal activities.
• Lower risk of complications such as infection and nerve damage.

Disadvantages

Despite its benefits, ECTR may have some disadvantages:

• Requires specialized training and equipment.
• Potential for incomplete release of the transverse carpal ligament.
• Risk of injury to the median nerve or other structures.

Recovery

Recovery from ECTR is generally quicker than from open surgery. Patients may experience some discomfort and swelling, which can be managed with pain medication and ice. Most patients can resume light activities within a few days and return to work within a few weeks, depending on the nature of their job.

Complications

As with any surgical procedure, ECTR carries risks of complications, including:

• Infection
• Bleeding
• Nerve injury
• Incomplete symptom relief

Outcomes

The success rate of ECTR is high, with most patients experiencing significant relief from symptoms. Long-term outcomes are generally favorable, with a low recurrence rate of carpal tunnel syndrome.

Also see

• Carpal Tunnel Syndrome
• Median Nerve
• Minimally Invasive Surgery
• Orthopedic Surgery