Endoscopic carpal tunnel surgery, also known as endoscopic carpal tunnel release (ECTR) has been around since the early to mid 90's and its popularity has been growing every year it seems.
ENDOSCOPIC is pronounced In-doe-skop-ic
There are several variations of the endoscopic carpal tunnel release.
The 2 portal or 2 incision technique is probably one of the most, if not the most common method used.
View video clip of actual surgery!!
The procedure is usually done with a Regional anesthetic Block, meaning that the nerves only going to the arm/hand are numb (i.e. the nerve sensations are blocked, therefore no pain can be felt).
Occassionally General anesthesia is used (where you are "put to sleep"). Also, your surgeon (or your anesthesia doctor) may give you something that will make you drowsy if you are really nervous about the surgery.
The area of the incision(s) on the skin will be throughly cleaned with a special germ killing liquid soap. A lot of hospitals use a solution called Betadine, (pronounced Bay-tuh-dine) it has iodine in it,so if you are allergic to iodine please let your doctor know before surgery!
As I mentioned earlier, the most common Endoscopic carpal tunnel procedure that I have seen, is where 2 small incisions are made about 1/2" long. One at the wrist and one at the palm area. Then a small flexible tube with a camera attached to it is used to literally look inside your wrist. This is called an Endoscope, it's about the diameter of a ball point pen!
Another tube called a cannula (pronounced Can-you-luh) is also used. These tubes allow the surgeon to see and work inside your wrist. Surgeons can visualize or tell where all the tiny but important structures in your wrist are located. [See cadaver hand] and ANATOMY OF THE CARPAL TUNNEL.
Remember there are other things in your wrist, such as arteries, viens, tendons and other nerves as well.
Endoscopic carpal tunnel surgery allows the surgeon to see the small wrist structures up on a TV screen while they perform the procedure.
A special knife is passed inside the cannula tube.This knife has a hook at the end that cuts backwards when the knife is pulled back out of the tube.Only the transverse ligament should be divided (or cut).
You may hear about some even newer types of endoscopic carpal tunnel surgery , one that uses a laser and one that uses a single incision. The single incision method is probably being used more than the laser method right now by some hand surgeons. The incision allows the surgeon to open the carpal tunnel just below the transverse carpal ligament and is a variation of a technique called the limited incision technique (LIT).
Whether your surgeon uses one of the endoscopic carpal tunnel procedures or the OPEN CARPAL TUNNEL RELEASE method, you should ask questions if you don't understand or want clarification of something.Usually the surgeon has one preferred method that he or she uses, but may use other methods as well. It just typically depends on the particulars of a certain case.
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