Endoscopic Carpal Tunnel Release
Carpal tunnel syndrome is one of the most common nerve compression conditions in the hand. It occurs when the median nerve is compressed as it passes through the carpal tunnel at the wrist.
Symptoms may include numbness, tingling, burning pain, night waking, clumsiness, weakness and difficulty with fine hand tasks. In more advanced cases, patients may develop loss of thumb strength and wasting of the small muscles at the base of the thumb.
Treatment Options
Many mild cases can be managed with splints, activity modification, injections or observation. When symptoms are persistent, severe, worsening or associated with weakness, surgery may be recommended.
Traditional open carpal tunnel release is a very reliable operation and remains an excellent treatment. It involves releasing the tight ligament over the carpal tunnel to take pressure off the median nerve.
Endoscopic carpal tunnel release is a more specialised technique that allows the same ligament to be released through a much smaller incision, usually around 5–7 mm at the wrist crease. A small camera is inserted, and the carpal tunnel is released under direct vision.
Why Endoscopic Release?
The main advantage of endoscopic carpal tunnel release is faster early recovery. Because the incision is small and avoids a larger cut through the palm, patients often have less early palm tenderness and are able to return to light activities and work sooner.
The nerve pain, tingling and night symptoms often improve quickly after surgery. Numbness can also improve, but usually recovers more slowly. In longstanding or severe compression, numbness and weakness may not recover completely, as this depends on how much nerve damage has occurred before surgery.
For suitable patients, endoscopic carpal tunnel release can also make it easier to treat both hands at the same time. Bilateral surgery can be particularly useful for patients with symptoms on both sides who wish to minimise time away from work or daily responsibilities.
Dr Ye’s Approach
Dr Ye offers both open and endoscopic carpal tunnel release. In suitable patients, endoscopic release is his preferred technique because of the smaller incision, faster early recovery and reduced palm tenderness.
The procedure is performed as day surgery. Patients come into hospital, have the carpal tunnel released and go home the same day. A dressing is placed over the wrist and is usually kept on for the first few days. Patients can begin using the hand and wrist straight away for light activities as comfort allows.
Most patients can resume many everyday activities soon after surgery, including driving once they are comfortable and safe to do so. Many patients feel significantly better by the two-week mark, although recovery varies depending on the severity and duration of nerve compression.
Risks and Recovery
The risks of endoscopic carpal tunnel release are similar to open carpal tunnel surgery. These may include infection, bleeding, scar tenderness, pillar pain, stiffness, incomplete symptom relief, nerve irritation or injury, recurrence and the need for further surgery.
Some patients may still experience tenderness around the carpal tunnel or base of the palm during recovery. Persistent numbness or weakness is more likely when the nerve has been compressed for a long time before surgery.
Dr Ye will discuss whether open or endoscopic carpal tunnel release is most appropriate based on symptom severity, nerve test results, hand function, work needs, previous surgery and patient preference.