Endoscopic Carpal Tunnel Release (Dr. Rosenfeld)
The carpal tunnel is a tight, non-expandable tunnel at the base of your palm. This tunnel is formed by bone on three sides and a thick ligament on the palm side. Your Median Nerve runs through this tunnel along with nine tendons (that bend your fingers). Carpal tunnel syndrome is a situation where there is not enough room for the nerve and it gets compressed in this non-expandable space. You feel the effects of this nerve compression as numbness, tingling, or a sense of your hands/fingers falling asleep, especially at night or when driving or holding the phone to your ear. Other symptoms include dropping items and trouble with small items like buttons.
The treatment for carpal tunnel syndrome is often surgical: the ligament that creates the roof of the tunnel is opened, making the tunnel larger and removing the pressure from the nerve. The results are generally rapid and successful.
Endoscopic carpal tunnel release allows release of this ligament with the use of a camera. This allows us to use a small incision (about the length of your nail) placed off of the palm to avoid impact areas. The surgery is performed as an outpatient with local anesthesia with a bit of sedation. You leave the surgery in a soft dressing and can use your hand for light things (typing, writing, eating, etc.) immediately. The dressing generally stays on (and stitches stay in) for a few days. Heavy lifting/gripping takes about a month to be comfortable. We do not recommend having both left and right carpal tunnel releases the same day, but one week apart is quite reasonable. You can return to work as soon as you are able; this depends on what you do for work. Desk work can commence almost immediately, while jobs that involve lifting and gripping may be delayed about a month.
Endoscopic carpal tunnel release has been proven to be of no higher risk compared to traditional open carpal tunnel release, and does provide a quicker initial recovery.
Surgery is beneficial in resolving the compression, removing the symptoms, and preventing permanent nerve damage. This surgery is straightforward, minimally invasive, outpatient, and requires little restrictions after surgery. If you are experiencing numbness, tingling, or hand pain you should be evaluated by a hand surgeon.