Endoscopic Carpal Tunnel Decompression

1994 ◽  
Vol 19 (1) ◽  
pp. 5-13 ◽  
Author(s):  
M. W. H. ERDMANN
Keyword(s):  
Pilot Study ◽  
Carpal Tunnel ◽  
Endoscopic Surgery ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Pinch Strength ◽  
Main Trial ◽  
Open Release ◽  
Prospective Pilot Study ◽  
Average Return

A study of endoscopic carpal tunnel release was carried out in three parts, consisting of initial cadaveric dissections, a prospective pilot study of 20 patients and a prospective, randomized trial of 71 patients comparing endoscopic with open decompression. In the main trial, 25 patients with bilateral symptoms underwent simultaneous endoscopic and open release, with the remainder randomized to one or other technique. Both techniques effectively decompressed the median nerve. A significant improvement in grip and pinch strength over 3 months was achieved in those undergoing endoscopic surgery. Average return to work was 14 days in the endoscopic series and 39 days in the open series. A complication rate of 35% was achieved with the transbursal endoscopic technique, 3.7% with the extrabursal endoscopic technique and 13.5% in the open series.

The Results of Carpal Tunnel Release: Open Versus Endoscopic Technique

1994 ◽  
Vol 19 (1) ◽  
pp. 14-17 ◽  
Author(s):  
S. BANDE ◽  
L. DE SMET ◽  
G. FABRY
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Open Release ◽  
Significant Difference ◽  
Open Versus ◽  
Portal Technique

We retrospectively compared two similar groups of patients who underwent either endoscopic decompression of the carpal tunnel (single portal technique, 44 patients) or open decompression (58 patients) during 1 year in our department. To find out whether there was any subjective difference between the results of the two techniques, we sent each patient a questionnaire and received a 95% response. No major complications occurred. Three endoscopic decompressions had to be abandoned, and open release was performed. We could not demonstrate any significant difference in relief of symptoms and return to work between the two groups. Patient satisfaction at 6 to 18 months follow-up was high with both techniques.

Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

2021 ◽  
pp. 175319342110017
Author(s):  
Saskia F. de Roo ◽  
Philippe N. Sprangers ◽  
Erik T. Walbeehm ◽  
Brigitte van der Heijden
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Open Release ◽  
Flap Coverage ◽  
Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release

2002 ◽  
Vol 84 (7) ◽  
pp. 1107-1115 ◽  
Author(s):  
Thomas E. Trumble ◽  
Edward Diao ◽  
Reid A. Abrams ◽  
Mary M. Gilbert-Anderson
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release

ENDOSCOPIC CARPAL TUNNEL RELEASE: SINGLE OR DOUBLE PORTAL?

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 89-94
Author(s):  
Malcolm H. Wicks
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Carpal Tunnel Release ◽  
The Other ◽  
Pinch Strength ◽  
Accelerated Rehabilitation ◽  
Light Sedation ◽  
Portal Technique ◽  
No Tourniquet

This report outlines my experience with 20 patients who underwent bilateral endoscopic carpal tunnel releases: one side by a uni-portal (Unit-Cut) release, the other by a two portal (modified Chow) technique at the same time. All patients were treated as out-patients, the operations being performed under local anaesthesia with light sedation, no tourniquet inflated, and with pressure bandage applied for twelve hours only. The patients underwent an accelerated rehabilitation programme beginning the same day, and were encouraged to use their hands as soon as possible. Grip and pinch strength return was similar for both techniques, the single portal being slightly quicker. Return to work averaged 8.5 days (range 3–25 days) and full activities returned by 14.3 days (range 1–40 days). When asked, the patient strongly preferred the single portal technique, i.e., 18 out of 20 patients.

Carpal tunnel release: a randomized comparison of three surgical methods

2013 ◽  
Vol 38 (6) ◽  
pp. 646-650 ◽  
Author(s):  
M. B. Larsen ◽  
A. I. Sørensen ◽  
K. L. Crone ◽  
T. Weis ◽  
M. E. H. Boeckstyns
Keyword(s):  
Grip Strength ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Randomized Controlled ◽  
Surgical Methods ◽  
Single Blind ◽  
Endoscopic Group

A single-blind, randomized, controlled trial was done to compare the results of carpal tunnel release using classic incision, short incision, or endoscopic technique. In total, 90 consecutive cases were included. Follow-up was 24 weeks. We found a significantly shorter sick leave in the endoscopic group. No significant differences in pain, paraesthesiae, range of motion, pillar pain, and grip strength could be found at 24 weeks of follow-up, although intermediate significant differences were seen, especially in grip strength, in favour of endoscopic technique. No major advantage to using a short incision could be found. There were no serious complications in either group. The results indicate that the endoscopic procedure is safe and has the benefit of faster rehabilitation and return to work.

The results of carpal tunnel release for carpal tunnel syndrome diagnosed on clinical grounds, with or without electrophysiological investigations: a randomized study

2012 ◽  
Vol 38 (1) ◽  
pp. 44-49 ◽  
Author(s):  
A. Żyluk ◽  
Z. Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Randomized Study ◽  
Clinical Importance ◽  
Nerve Conduction Studies ◽  
Pinch Strength ◽  
Tunnel Syndrome ◽  
To Receive

We compared the results of carpal tunnel release in patients with the diagnosis of carpal tunnel syndrome based on only clinical grounds and those diagnosed on clinical and electrophysiological grounds. Ninety-three patients, 83 women (89%) and ten men (11%), meeting the criteria of ‘typical’ carpal tunnel syndrome, were randomly assigned to receive carpal tunnel release with ( n = 45, 48%) or without ( n = 48, 52%) nerve conduction studies. Patients were followed-up at 1 and 6 months, by assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 months assessments. Statistically significant differences were noted in three-point pinch strength and sensation; however, they were not of clinical importance. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after nerve conduction studies and, therefore, nerve conduction studies can be omitted.

ENDOSCOPIC CARPAL TUNNEL RELEASE FOR RECURRENT CARPAL TUNNEL SYNDROME AFTER PREVIOUS OPEN RELEASE

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 235-239 ◽  
Author(s):  
Lam Chuan Teoh ◽  
Puay Ling Tan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Surgical Release

Recurrent carpal tunnel syndrome from various causes has been shown to occur in up to 19% of patients. Endoscopic carpal tunnel release has been used to decompress the median nerve in carpal tunnel syndrome for many years. However, endoscopic release for recurrent carpal tunnel syndrome after previous surgical release has not been reported. Nine hands in six patients had recurrent carpal tunnel syndrome five to 20 years after previous open carpal tunnel release. All the cases were successfully treated with endoscopic release.

scholarly journals Minimally Invasive Carpal Tunnel Release (CTR) Using the Wongsiri Technique with MiniSURE

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sunton Wongsiri ◽  
Wongthawat Liawrungrueang
Keyword(s):  
Minimally Invasive ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Endoscopic Surgery ◽  
Operative Time ◽  
Carpal Tunnel Release ◽  
Line Of Sight ◽  
Open Technique ◽  
Working Space ◽  
Carpal Tunnel Surgery

Introduction. The standard open technique for carpal tunnel surgery has wound problems and complications significantly more than minimally invasive surgery using the Wongsiri technique with MiniSURE Kit® (Surgical Innovation Healthcare Co., Ltd, Bangkok, Thailand) and in particular, the open technique surgery requires a longer time for return to work. CTR surgery with endoscopic devices improves the results with fewer wound problems when compared with the commonly used open technique; however, nerve complications and injury are more prevalent with endoscopic surgery than with the open technique. The Wongsiri technique produces good results with new medical devices such as the MiniSURE View, for improved vision and line-of-sight, and the MiniSURE Cut for improved and complete cutting via the supraretinacular technique that may reduce the nerve problems associated with endoscopic tooling in the carpal tunnel. Purpose. To evaluate the results of the operation and postoperative outcomes of the Wongsiri technique with a MiniSURE Kit®. Methods. 20 patients underwent carpal tunnel release using the Wongsiri technique and a MiniSURE Kit® with a five-step surgery: MIS starts when the surgeon makes a 1.5–1.8 cm incision, creates a working space, inserts the visual tube of MiniSURE View, inserts the freer, and then cuts the transverse carpal ligament by using the MiniSURE Cut. Results. All 20 successes of the Wongsiri technique and MiniSURE Kit® surgery occurred within 6.8 minutes operative time and a 12 mm wound size. A single outlier, in one case (6.7%), the patient experienced pillar pain which abated within one month. Patients can return to work in 7.3 days. Conclusions. The Wongsiri technique with the MiniSURE Kit® demonstrated good outcomes similar to the endoscope. By contrast with the endoscopic surgery, the Wongsiri technique with the MiniSURE Kit® reduced preop, operating, and postop time, many resources, and significant costs and resulted in no nerve problems or complications.

Morphologic Analysis of the Carpal Tunnel and Median Nerve Following Open and Endoscopic Carpal Tunnel Release

Hand ◽  
2019 ◽  
pp. 155894471986171 ◽  
Author(s):  
Blair R. Peters ◽  
Amanda M. Martin ◽  
Brett F. Memauri ◽  
Hardy W. Bock ◽  
Robert B. Turner ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Resonance Imaging ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Significant Difference

Background: Endoscopic carpal tunnel release (ECTR) has purported advantages over open release such as reduced intraoperative dissection and trauma and more rapid recovery. Endoscopic carpal tunnel release has been shown to have comparable outcomes to open release, but open release is considered easier and safer to perform. Previous studies have demonstrated an increase in carpal tunnel volume, regardless of the technique used. However, the mechanism by which this volumetric increase occurs has been debated. Our study will determine through magnetic resonance imaging (MRI) analysis the morphologic changes that occur in both open carpal tunnel release (OCTR) and ECTR, thereby clarifying any morphologic differences that occur as a result of the 2 operative techniques. We hypothesize that there will be no morphologic differences between the 2 techniques. Methods: This was a prospective study to compare the postoperative anatomy of both techniques with MRI. Nineteen patients with clinical and nerve conduction study–confirmed carpal tunnel syndrome underwent either open or endoscopic release. Magnetic resonance imaging was performed preoperatively and 6 months postoperatively in all patients to examine the volume of the carpal tunnel, transverse distance, anteroposterior (AP) distance, divergence of tendons, and Guyon’s canal transverse and AP distance. Results: There was no significant difference in the postoperative morphology of the carpal tunnel and median nerve between OCTR and ECTR at 6-month follow-up on MRI. Conclusion: We conclude that there are no morphologic differences in OCTR and ECTR. It is an increase in the AP dimension that appears to be responsible for the increase in the volume of the carpal tunnel.

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