Open v. Endoscopic Carpal Tunnel Surgery

Carpal tunnel release surgery is a medical procedure that is used to relieve pressure on the median nerve in the wrist by severing the carpal ligament. This procedure, which can eliminate the symptoms of carpal tunnel syndrome, can be accomplished as open release surgery or endoscopic surgery.

Open Release Surgery

• Open release surgery requires a one- to two-inch incision in the wrist. Once the incision has been made, the surgeon is able to clearly see, and sever, the carpal ligament. The cutting of the carpal ligament opens the carpal tunnel, which is composed of the carpal ligament and bone. This action relieves the symptoms of carpal tunnel syndrome.

Endoscopic Surgery

• Endoscopic surgery for carpal tunnel syndrome requires two smaller incisions. The surgeon inserts a small lighted tube into each incision, and feeds a camera through one tube, and a small knife through the other. The camera is connected to a monitor, which shows a view of the carpal ligament, allowing the surgeon to cut it without such a large incision.

Open Release Recovery

• Patients recovering from open release surgery require more recovery time than those who have had endoscopic surgery, but long term recovery is approximately the same. People who have had open release surgery for their carpal tunnel syndrome are more likely to need their carpal ligament severed again in a repeat procedure.

Endoscopic Recovery

• Recovery from endoscopic surgery tends to be faster than open release surgery, with patients able to return to work sooner. However, patients who have had endoscopic surgery to relieve their carpal tunnel syndrome symptoms are more likely to report long term pain at the site.

Considerations

• Open release surgery and endoscopic surgery are both outpatient procedures that are accomplished under local anesthesia. These procedures can relieve the symptoms of carpal tunnel syndrome, but may force the patient to change their occupation, to avoid the activities that caused them to develop carpal tunnel syndrome. Both open release surgery and endoscopic surgery also carry the risk of permanent nerve damage, pain or infection.