How Is Carpal Tunnel Surgery Done?

Carpal Tunnel Surgery Facts

According to the National Institute of Neurological Disorders and Stroke, carpal tunnel release is one of the most commonly performed surgeries in America. Carpal tunnel surgery is generally performed as an outpatient procedure with local anesthesia. Not only are individuals usually awake for carpal tunnel surgery, but they are also able to go home the same day. According to the Mayo Clinic, surgery for carpal tunnel release is generally only recommended if the following three conditions are met: carpal tunnel pain is persistent despite conservative treatment; you have decreased wrist and hand strength; and the muscles in your hand are beginning to deteriorate. There are two types of carpal tunnel surgery--open-release surgery and endoscopic surgery. Both involve cutting a major ligament in the hand to relieve median nerve pressure. The two options differ mainly in the surgical approach.

Open-Release Carpal Tunnel Surgery

The more traditional procedure for carpal tunnel surgery, open-release surgery involves cutting open a small area in the wrist so the surgeon can get a good view of the area without having to use a camera and a monitor. First, a local anesthetic is administered to the hand and wrist. Next, the surgeon makes an incision in the palm of the hand. According to the Mayo Clinic, this incision may be anywhere from one to two inches long, and may or may not extend down to the wrist. Once the area is open, the surgeon cuts the structure known as the carpal ligament, which is a band of tissue that surrounds the tendons and nerves that supply the hand. Overall, the procedure takes less than half an hour. After the carpal ligament is cut, the surgeon seals the palm back up. The carpal ligament remains open underneath the skin.

Endoscopic Carpal Tunnel Surgery

A newer form of carpal tunnel surgery, endoscopic carpal tunnel release involves much smaller incisions as well as the use of tiny cameras and a monitor for viewing. You may or may not remain fully awake during this procedure. According to the Mayo Clinic, some surgeons sedate their patients (though not with general anesthesia), while others choose a local anesthetic. Unlike an open-release, the surgeon performing an endoscopic carpal tunnel surgery makes two smaller incisions, one in the palm and the other in the wrist. Each incision is about half an inch long. He then inserts a tiny camera as well as tiny surgical instruments, watching his work on a monitor screen. Like an open-release, the surgeon cuts the carpal ligament and then removes the instruments and camera. The two cuts are then sealed. The average endoscopic carpal tunnel release takes approximately ten minutes.