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Endoscopic Carpal Tunnel Release and Open Carpal Tunnel Release

Surgical Treatment:

Surgery may be considered if you do not gain relief from nonsurgical treatments. The decision whether to have surgery is based mostly on the severity of your symptoms.

In more severe cases, surgery is considered sooner because other nonsurgical treatment options are unlikely to help.

Endoscopic method:

Some surgeons make a smaller skin incision and use a small camera, called an endoscope, to cut the ligament from the inside of the carpal tunnel. This may speed up recovery.

Endoscopic surgery uses a thin, flexible tube with a camera attached (endoscope). The endoscope is guided through a small incision in the wrist (single-portal technique) or at the wrist and palm (two-portal technique). The endoscope lets the doctor see structures in the wrist, such as the transverse carpal ligament, without opening the entire area with a large incision.

The cutting tools used in endoscopic surgery are very tiny and are also inserted through the small incisions in the wrist or wrist and palm. In the single-portal technique, one small tube contains both the camera and a cutting tool.

During endoscopic carpal tunnel release surgery, the transverse carpal ligament is cut. This releases pressure on the median nerve, relieving carpal tunnel syndrome symptoms.

The small incisions in the palm are closed with stitches. The gap where the ligament was cut will eventually fill with scar tissue.
If you have endoscopic carpal tunnel release surgery, you likely will not have to stay in the hospital. You can go home on the same day.

What To Expect After Surgery

You can expect a shorter recovery period after an endoscopic surgery than after open surgery, because the procedure does not require cutting the palm open and disturbing a large area of the hand.
The pain and numbness may go away right after surgery, or it may take several months. Try to avoid heavy use of your hand for a couple of weeks.

Open release for CTS :

Open release for CTS is occasionally done using a general anesthetic (one that puts you to sleep). More often, it is done using a regional anesthetic. A regional anesthetic blocks the nerves going to only a portion of the body. Injections of medications similar to lidocaine are used to block the nerves for several hours. This type of anesthesia could be an axillary block (only the arm is asleep) or a wrist block (only the hand is asleep). The surgery can also be performed by simply injecting lidocaine around the area of the incision.
Once you have anesthesia, your surgeon will make sure the skin of your palm is free of infection by cleaning the skin with a germ-killing solution.

An incision is made at the base of the palm of the hand, usually about two inches long. This allows the doctor to see the transverse carpal ligament. During open carpal tunnel release surgery, the transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome.