Endoscopic Carpal Tunnel Release

Endoscopic carpal tunnel release (ECTR) is a minimally invasive surgery designed to relieve the symptoms of carpal tunnel syndrome. The option for surgery is offered when non-surgical alternatives like anti-inflammatory medications and lifestyle changes fail to provide any relief.

What is the procedure for ECTR?

Endoscopic surgery involves inserting a thin tube called an endoscope that has a camera attached to it, as described in the steps below:

  1. The surgeon first makes a small incision, about 1.5 centimeters in length, in your wrist (known as the single-portal technique).
  2. The endoscope is then inserted through the incision, enabling the surgeon to view structures within the carpal tunnel, including and most importantly the median nerve, the flexor tendons to the fingers and the white band of connective tissue named the Transverse Carpal Ligament (TCL). The TCL forms the roof of the carpal tunnel underneath which the median nerve traverses along with flexor tendons to the fingers.
  3. The surgeon then deploys the cutting device through the endoscope and under direct visualization divides the TCL, so it springs open. The incisions is finally stitched or closed with sterile glue.

The goal of the surgery is to fully release release the Transverse Carpal Ligament in order to decompress the median nerve as it passes through the carpal tunnel in your wrist. This creates more room within the carpal tunnel, releasing pressure on the nerve, and hence, relieving your symptoms.

How long does it take to recover after endoscopic carpal tunnel release?

ECTR offers quicker recovery, less pain on the operated hand, and earlier return to work/daily activities compared to the open carpal tunnel surgery. Many patients feel relief of their numbness and tingling that wakes them up at night within 1-2 days after surgery. Most patients can return to light-duty work after an average of 2 to 7 days, and can regain full function of their hands within about four weeks.

The success rate after carpal tunnel release is higher than 95% with very fewer patients experiencing a return of symptoms several years after surgery.

What precautions to take after ECTR?

There are very few restrictions after surgery. The soft gauze postoperative dressing should stay on for 4 days and should be kept dry. Activity can commence as tolerated right after surgery.

What are the risks associated with ECTR?

You can expect some minor pain and swelling for a few weeks. However, severe complications are rare. Incomplete release of the TCL with continuing numbness is reported to be the most common complication of endoscopic carpal tunnel release. Depending on its severity, the numbness may take longer to resolve.

Nerve symptoms that persist after the endoscopic procedure are usually due to the severity of disease with longer the durations of carpal tunnel syndrome, the more severe the nerve damage, and hence, possibly a slower recovery.

Complications are less likely with the endoscopic technique when performed by an experienced hand surgeon like Dr. Wayne Weil who is a board-certified orthopedic surgeon, acknowledged for his expertise in hand and wrist surgeries. If you suffer from intractable symptoms of median nerve compression, contact the Orthopedic Specialists of Seattle to schedule an appointment with Dr. Wayne Weil.