When carpal tunnel surgery is to be performed, it may be performed through a traditional “open” approach, or through a small incision using a scope. In endoscopic carpal tunnel release, a small incision is made on the forearm near the wrist and a small camera (known as an endoscope) is inserted to visualize the transverse carpal ligament. A specialized knife is then used to cut the transverse carpal ligament to relieve pressure from the median nerve.
While long-term outcomes of open and endoscopic carpal tunnel release may be similar, there are certain benefits to endoscopic carpal tunnel release when indicated. As with all surgical procedures, each of these surgical treatment methods has its own potential risks which you can discuss with your doctor prior to surgery. A recent study revealed that the rates of complications overall are similar, however hand pain was lower in the endoscopic group compared to the open group (1). Another significant benefit to endoscopic release that has been shown in studies is that endoscopic release has allowed an “earlier return to work and improved strength during the early postoperative period” (2). One randomized study of patients undergoing bilateral carpal tunnel release (with one performed endoscopically and one performed open) showed patient satisfaction to be higher at three months postoperatively for the endoscopic release (3).
References
- Endoscopic versus open carpal tunnel release for idiopathic carpal tunnel syndrome: a meta-analysis of randomized controlled trials. Dongqing Z, et al. J Orthop Surg Res. 2015;10:12
- Open versus endoscopic carpal tunnel release: A meta-analysis of randomized controlled trials. Sayegh ET, Strauch RJ. Clin Orthop Relat Res. 2015 Mar;473(3):1120-1132.
- Endoscopic carpal tunnel release is preferred over mini-open despite similar outcome: A randomized trial. Kang HJ, et al. Clin Orthop Relat Res. 2013 May;471(5):1548-1554.