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Carpal tunnel syndrome is a condition which causes pain and
numbness in one or both hands. Until recently, the classic
operation for this condition has involved an incision across
the entire base of the palm, often leaving the patient with
considerable discomfort for several weeks after their surgery.
Many people actually wait too long before they even have the
surgery as they are afraid or unable to give up the use of the
hand for the necessary recovery period.
Over the past ten years, hand surgeons have developed an
endoscopic technique for this condition. Endoscopic carpal
tunnel release (ECTR) is an anatomically logical way to
perform the same surgery that others have been doing through
an open incision. The procedure makes use of the body's
natural ability for tissues to be separated from one another,
to get the surgical instruments into the carpal tunnel where,
with the aid of a video monitor system, the surgery is
completed.
This procedure has the same long term benefits as its
predecessor, the open technique. The major difference is the
markedly shorter recovery period. Patients leave the operating
room with a light gauze bandage which allows them full use of
their hand. They remove this on their own on the second day
after surgery and are then allowed to shower, then dry the
three stitches, and cover them with a clean Band-Aid each day.
Many people return to work or golf within the first week. The
pain and tingling symptoms are usually relieved immediately.
Patients who have delayed their surgery for some time and have
true numbness in their digits will find that it can take from
weeks to months to get their feeling to return, depending on
how severely damaged the nerve has become.
Despite ECTR's overwhelming advantages, most hand surgeons
continue to perform "open" carpal tunnel surgery. The
technique requires added training and certification. My Hand
Surgery Fellowship in Buffalo, New York, was with surgeons who
participated in the earliest multi-center studies for ECTR. My
training with this technique extended over a full year, with
master hand surgeons who helped develop ECTR. My experience
makes me quite confident that ECTR is my procedure of choice
for most patients requiring carpal tunnel release.
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