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Surgical Procedures for Carpal Tunnel Syndrome

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When more conservative treatments fail, surgery is a very successful option. Only 5% of patients experience symptoms after surgical treatment.

Carpal Tunnel Release

Endoscopic Release of Carpal Tunnel
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This simple procedure can be done in several ways, depending upon your particular case and the surgeon's experience and preference.

The thick ligament on the palm side of your carpal tunnel is cut, allowing the contents of the tunnel to expand and the pressure to be reduced. The procedure is ordinarily done in an outpatient setting under local anesthesia, some circumstances may recommend that the whole arm be "put to sleep" with a nerve block. General anesthesia—where you’re "totally under"—is rarely necessary.

You’ll be put into a hospital gown and taken to a surgical suite (operating room). After you lie down on an operating table, at least one intravenous line will be attached to a needle in your vein, and monitors may be attached to you to keep track of your heartbeat, blood pressure, and oxygen levels. If you've requested it, you may be sedated for additional comfort.

Approaches to carpal tunnel release include:

  • The open approach, which simply cuts through the skin to expose the ligament, then cuts across the ligament with scissors.
  • Some surgeons prefer a smaller incision that accommodates only the scissors.
  • Certain circumstances may dictate that an arthroscope be used to see the carpal tunnel in greater detail. This procedure will take slightly longer, mostly to set up the equipment. During the arthroscopy, the surgeon can put small instruments into the carpal tunnel to cut the ligament.

Each of these procedures takes only a few minutes. Afterward your incision will be closed, and you will be taken briefly to a recovery room where the immediate effects of the sedation or anesthesia can wear off and nurses can monitor you.

Revision Information

  • American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org .

  • American Association of Neurological Surgeons/Congress of Neurological Surgeons website. Available at: http://www.aans.org .

  • Mayo Foundation for Medical Education and Research website. Available at: http://www.mayo.edu .