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Carpal Tunnel Release

Endoscopic Carpal Tunnel Release
For the endoscopic surgery, your doctor will then begin by making an approximately one-inch incision, or cut, on the palm side of your wrist. Depending on the specific technique used, a second small incision may be made in your hand.
 
An instrument is then inserted into the carpal tunnel to guide the endoscope into place. The endoscope is a long, thin tube, about the size of a writing pen. It is similar to a camera in that it allows your doctor to see inside your wrist by projecting the image onto a TV monitor. It can also take pictures and videotape the procedure. Once inside the carpal tunnel, your surgeon can look at the carpal ligament, or the "ceiling" of the carpal tunnel, on a video screen.
 
After proper positioning of the endoscope away from the nerves and arteries, the carpal ligament is cut using a special device that is attached to the endoscope. The surgeon is able to confirm that the entire ligament is cut by watching it on the video screen.
 
Open Carpal Tunnel Release
For the open type of this surgery, your doctor will begin by making a two- to three-inch incision on the palm side of your wrist. If you are awake, you might feel some pressure as this incision is made. Your doctor will then locate the carpal ligament. This ligament will then slowly be cut.
 
Once the entire ligament has been cut, the tendons in the carpal tunnel are examined. If the synovial coverings on the tendons are excessively thickened, they are removed to allow more space for the nerve. This will not affect the tendons' function.
 
The carpal ligament (which is the ligament that is cut) is left open, rather than sewn together. This gap eventually fills with scar tissue.
 

Finishing the Procedure

To finish either type of carpal tunnel release, the wound will be cleaned thoroughly, and the skin will be closed with stitches. A bandage and splint is then applied. The splint is used to prevent excessive movement of the wrist, to protect the surgical site, and to promote healing. The splint is bulky and will cover your hand, wrist, and forearm.
 
At the end of the carpal tunnel release, you will be awakened while still in the operating room and then transported to the recovery room.
 
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