Frisco & Dallas Endoscopic Carpal Tunnel Release

Endoscopic surgeries are intended to be far less invasive and with smaller incisions than other types of surgeries. They involve the use of a very thin tube with an endoscope (camera) attached to it. The surgeon makes either one (single-portal) or two (two-portal) small incisions in the wrist. Through these incisions, the surgeon inserts the endoscope. This allows the surgeon to see all of the wrist’s structure without completely opening the area with a large incision. 

All tools used in an endoscopic carpal tunnel release are extremely small. Along with the endoscope, they are inserted through the incision/s on the wrist or palm. The surgeon uses the cutting tool to cut the transverse carpal ligament, which then releases pressure on the median nerve. This, in turn, relieves the patient of their carpal tunnel syndrome symptoms. Once the surgery is complete, the surgeon wraps the wound with waterproof bandage material. Eventually, the area around the cut ligament fills with scar tissue. In most cases, stitchless carpal tunnel release is performed as an outpatient procedure, meaning that the patient returns home after the surgery.

Our orthopedic surgeons consider endoscopic carpal tunnel release for the following reasons.

• You have undergone a significant amount of nonsurgical treatment, with no improvement of the symptoms. Generally, providers do not consider surgery until at least several weeks or months pass with ongoing nonsurgical treatment options.
• You have severe symptoms, such as loss of feeling, loss of coordination, or loss of strength in the fingers, hand, or thumb. These symptoms restrict your daily activities on a regular basis.
• Your median nerve has sustained damage, or there is a significant risk of damage to the nerve.
• Surgeons consider this method over other methods in cases where both wrists require surgery, or where patients use wheelchairs, walkers, or crutches. This consideration is due to the shortened healing time when compared to other methods.

Most of our patients who undergo endoscopic carpal tunnel release experience fewer or no symptoms of pain and numbness after their surgery. Only rarely do we see pain and numbness return to patients once they go away. After the surgery, some patients experience temporary loss of strength in the hand while trying to grip onto or pinch an item. In cases where the muscles of the thumb have weakened or dissipated prior to surgery, some patients experience limited function of the hand, even after the surgery.

All surgeries have risks, but the chance of complications for stitchless carpal tunnel release are very low. Nerve damage and other major complications happen in only 1% of surgeries. Below, we list other potential complications that accompany this specific surgery, as well as surgeries in general.

• Nerve damage
• Blood vessel damage
• Tendon damage
• Possible infection
• Risks associated with general anesthesia

General anesthesia has its own risks, such as heart attack, stroke, blood pressure changes, pneumonia, muscle damage, and more. However, most endoscopic carpal tunnel release surgeries involve local anesthesia instead.

In general, recovery time depends heavily on which hand underwent operation. It also depends on exactly how the patient uses their hands on a daily basis. Below, we demonstrate the relatively speedy recovery for patients of stitchless carpal tunnel release.

• Those who undergo surgery on their nondominant hand typically resume their normal level of activity after around 1 to 2 weeks of recovery.
• Those who undergo surgery on their dominant hand usually wait around 4 weeks or so before resuming their normal level of activity and using their hands for work.
• Sometimes, a certain amount of pain or numbness lingers once the surgery is complete. It takes time for the body to heal, and for the scar tissue to form in place of the carpal ligament. At most, several months will pass before the scar tissue is fully formed.

Before the surgery, your dedicated surgeon will brief you on how to prepare. Below, we list common instructions that we give patients before they undergo stitchless carpal tunnel release.

• Discuss your current medications with your surgeon. Depending on what you take, they might ask that you stop taking certain medications for at least one week prior to the surgery. Examples of these medicines include aspirin, ibuprofen, or blood thinners.
• If you have any symptoms of cold, fever, or a virus prior to the surgery, tell your doctor right away.
• Arrange for someone to drive you to and from the hospital for your surgery.
• Lastly, avoid eating for at least 6 and up to 12 hours prior to surgery.

All surgeries require certain follow-up care or post-operative instructions. Immediately after the surgery, your surgeon will apply and bandage to the area. Sometimes, they apply a splint as well. These intend to protect your hand and arm. We maintain that it takes at least 4 weeks to fully recover from this procedure. Below, we list steps you can take to make your own recovery a little easier.

• Take pain medications as prescribed.
• Apply cold compresses to the hand and wrist area every few hours for 20 minute intervals.
• Take showers and baths according to your doctor’s instructions.
• Avoid lifting heavy objects if at all possible.
• Keep your hand and arm elevated for a few days after surgery. This helps to reduce pain and swelling.

For at least a week after your surgery, your surgeon will recommend that you wear your splint and your bandages. In some cases, we also recommend physical therapy or special exercises. Generally, recovery time depends on the amount of damage your median nerve suffered prior to surgery.