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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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