Endoscopic Carpal Tunnel Surgery For Carpal Tunnel Syndrome

By Author: Asitava Bose
Total Articles: 14
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What is Carpal Tunnel Syndrome?


The ‘carpal tunnel’ is the tunnel-like structure of the wrist. The wrist bones called the carpals form the bottom and sides of the tunnel. The top of this tunnel is a strong band of connective tissue called the transverse carpal ligament. The median nerve travels through this structure and this nerve controls feelings in the palm side of the thumb and fingers. It also controls the muscles of the thumb. Flexor tendons travel through the carpal tunnel also. These are necessary to bend the fingers and thumb.


The median nerve travels from the forearm into the hand through this tunnel in the wrist. The median nerve controls feeling in the palm side of the thumb, index finger, and long fingers. The nerve also controls the muscles around the base of the thumb. The tendons that bend the fingers and thumb also travel through the carpal tunnel. These tendons are called flexor tendons.


Carpal tunnel syndrome transpires when the tissues adjacent to the flexor tendons in the wrist swell and put pressure ...
... on the median nerve. These tissues are called the synovium and they lubricate the tendons to make it easier to move the fingers. With carpal tunnel syndrome, the synovium swells and narrows the confined space affecting the median nerve.


What is Involved with Endoscopic Carpal Tunnel Release Surgery?


Endoscopic surgery involves the use of a thin, flexible tube that has an attached camera on it. This small camera is known as an endoscope and it is guided through a small incision of the wrist to view inside the carpal tunnel area. The endoscope allows the orthopedic specialist to see the structures of the wrist without opening the entire area with a large cut. The surgical cutting instruments are inserted through other tiny incisions to allow the surgeon to repair the carpal tunnel region of the wrist.


The transverse carpal ligament is cut during endoscopic carpal tunnel release surgery and this ‘releases’ the pressure that is on the median nerve and thus relieves carpal tunnel syndrome symptoms. The small incisions made to the surgical site are closed with sutures and the ligament that was cut will eventually heal by being filled with scar tissue. Most of these types of procedures are done on an outpatient basis, so you can go home soon after your surgery.


Why Is Carpal Tunnel Release Surgery Done?


If you still have symptoms even after a long period of nonsurgical treatment, your orthopedic specialist may recommend carpal tunnel release surgery. If there are signs of nerve damage, the surgeon may urge you to consider this procedure immediately. Another reason the surgery is done is that severe symptoms that persist restrict your activities of daily life.

How Well Does It Work?
Most people who have surgery for carpal tunnel syndrome have fewer or no symptoms of pain and numbness in their hand afterwards. In rare incidences, however, the symptoms return or there is temporary loss of strength when gripping or pinching objects. The surgery works best when there is no nerve damage or serious damage to the internal structures of the wrist. If the muscles are wasted away or weakened before the surgery, there is more likelihood that there will be decreased hand strength and function after the procedure.


What Should I Expect After Surgery?


There is a shorter recovery period after an endoscopic surgical procedure than after open surgery. This is because the structures of the hand and wrist are not manipulated and there is less of an incision to heal. The pain and numbness may go away immediately following the endoscopic carpal tunnel release surgery or it may take a few weeks.


You will have to avoid heavy use of your hand for two or three weeks following this procedure. Your doctor will advise you on when you can return to work and this will depend on whether or not your dominant hand was operated on, what is involved in your work activities, and the effort that you put into your rehabilitation and physical therapy.