Hand and Wrist Information Center
	Our Specialist Physicians:	B.J. Luskin, MD

Endoscopic Carpal Tunnel Surgery Brandon J. Luskin, M.D.

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.