More Than A Painful Wrist
Carpal tunnel syndrome (CTS) is a common but painful hand condition that affects 1-3 people out of every 1,000 each year. Compression of the median nerve causes pain due to a narrowing of the passageway in the wrist called the carpal tunnel. In most cases, CTS is triggered by repetitive motion of the wrist or hand, often due to work or sports. However, further studies found congenital predispositions wherein some families have smaller carpal tunnels than others. Endoscopic carpal tunnel surgery is often the go-to method of surgeons to treat severe cases.
A release you need
When it comes to CTS, A doctor will usually recommend non-surgical treatments first. These treatments include over-the-counter (OTC) pain medications, physical therapy, and wrist splints. Corticosteroid shots and ergonomic changes to work equipment also can help. However, if the symptoms persist for more than 6 months, an orthopedic surgeon will recommend surgery to help. Surgical treatment will aim to divide and release the transverse carpal ligament, often through endoscopic means.
The endoscopic approach
Open surgery is one approach to treating carpal tunnel syndrome. Another is endoscopic carpal tunnel release surgery, first introduced in the late 1980s. A Japanese orthopedic surgeon cut the transverse carpal ligament using an endoscope. The endoscopic approach uses 2 small incisions the size of buttonholes to access the tissue. From there, the surgeon can use small tools to complete the repair. Using this approach has 5 benefits for both the patient and the doctor.
1. Lower risk of complications
Open surgery gives the surgeon a broader view of the carpal tunnel and surrounding tissue. The argument against endoscopic means is that the surgeon has limited surgical site visualization. However, studies show that the opposite is true. The open technique resulted in more issues, such as infection, hypertrophic scars, and scar tenderness. In other words, there is a lower risk of complications with endoscopy.
2. Less scarring and discomfort
Since the surgeon only inserts a tiny camera and instruments to perform the endoscopy procedure, only small incisions are necessary. With smaller incisions, the resulting scar is also smaller, and there is less discomfort. In addition, patients are more satisfied with the endoscopic approach, and good clinical outcomes are achieved more quickly.
3. Same-day release
In endoscopic carpal tunnel release, a local anesthetic numbs the hand and wrist. After the procedure, the medical team monitors the patient for a few hours. Once all is well, the patient can go home the same day with the help of a family member or friend. The procedure is popular in ambulatory surgical centers (ASC), meaning patients can schedule surgery conveniently.
4. Fantastic results
The long-term results of endoscopic and open surgeries are similar. However, endoscopic surgery produces better short-term outcomes since no scar tenderness exists. The patient also would not require additional time for a long incision to heal. Best of all, endoscopic surgery has a success rate of over 90%.
5. Faster recovery than open release
Endoscopic surgery, on average, has a faster recovery than open surgery. For example, 3 months after surgery, patients who underwent endoscopic release had greater grip strength, pinch strength, and hand dexterity than open release. As a result, patients who want to go back to work or physical activity quickly will find more benefits using endoscopic means.
Talk to your surgeon
If surgery is necessary for carpal tunnel release, ask about endoscopy as an option. With the advancements in the medical field and technology, patients get the same functional outcomes with fewer complications and faster recovery. Endoscopic surgery also has higher satisfaction rates. Considering these benefits, the future of treating CTS looks bright.