- Minimally invasive surgery, or endoscopic carpal tunnel release, is performed by inserting special instruments and an endoscope through one or two small ½-inch incisions in the wrist. The endoscope is a thin, lighted instrument with a small camera that transmits pictures of the inside of the wrist to a video screen. Your surgeon sees the surgical area on the video screen while performing the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make a small incision(s) instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.
- Open surgery is performed by making a two inch incision in the wrist. Open surgery allows your surgeon to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.
Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different carpal tunnel procedures and ask why your surgeon will use a particular type for you.
Types of anesthesia that may be used
Your surgeon will perform carpal tunnel release using either general anesthesia or regional anesthesia, depending on the specific procedure.
- General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and do not feel any pain.
- Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb an area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable. This is the most common type of anesthesia used for carpal tunnel release.
What to expect the day of your carpal tunnel release
The day of your surgery, you can generally expect to:
- Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form. You should verify the correct site with the surgical staff.
- Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
- Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have. The surgeon will perform some types of nerve blocks.
- Your team will start an IV and clean your wrist, hand and arm.
- The anesthesiologist, nurse anesthetist, or surgeon will start your anesthesia.
- A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
- Your surgeon will make an incision on the palm side of the wrist and cut the carpal ligament. The incision is closed with stitches.
- Your team will apply a dressing and splint to your wrist.
- The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and all vital signs are stable.
What are the risks and potential complications of carpal tunnel release?
As with all surgeries, carpal tunnel release involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
Complications of carpal tunnel release are uncommon but include: