Endoscopic Carpal Tunnel Release
The term endoscopic refers to the use of a device called an endoscope. An endoscope is a device containing a camera that is usually flexible and utilizes fiber optics to transmit light and images. Endoscopes are commonly used in medicine to allow practitioners to view internal areas of the body in a minimally invasive fashion. Examples include: endoscopy of the upper GI tract, colonoscopy, arthroscopy, etc.
Endoscopic carpal tunnel release is the process of using an endoscope (see definition above) to perform a carpal tunnel release procedure in a more minimally invasive manner than traditional carpal tunnel surgery. The endoscope and instruments are inserted through two approximately 1/2 inch incisions. The surgeon can visualize the internal structures of the wrist through the camera which is attached to a monitor. The transverse carpal ligament, once visualized, is then released using micro instruments while viewing the surgical field on the monitor. Because, theoretically there is less surgery involved using an endoscopic approach, the recovery time is shorter. However, the surgical time may be longer than traditional carpal tunnel release procedures.
There is debate about this topic and endoscopic release is a relatively new procedure compared to the traditional “open” approach. In 2015 The journal Clinical Orthopaedics and Related Research published a meta-analysis (a review of all existing publications) comparing the results of both approaches. The article was titled
Open versus Endoscopic Carpal Tunnel Release: A Meta-analysis of Randomized Controlled Trials and published by Eli Sayegh Robert Strauch.
The authors concluded the following: the endoscopic approach provided a quicker return to work and a lower chance of scar tenderness but had a higher chance of nerve damage. However, most of the nerve damage was temporary. Otherwise, the results of each procedure were clinically the same at 6 months.
There is no one answer, every person is unique with unique circumstances and desires. The best thing to do, is to understand each procedure and their pros and cons and discuss the options with your surgeon. It is important that your surgeon has a significant amount of experience in performing whichever procedure you are going to have. If your surgeon does not perform endoscopic carpal tunnel release, you may want to have a second consultation with a surgeon that does so that you can better compare both approaches and how they relate to your particular circumstances.