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Single Incision Endoscopic Carpal Tunnel Release

Light rock music Treatment options for carpal tunnel syndrome include nonsurgical options and surgical options. As far as the nonsurgical options for treatment of carpal tunnel, that would include nightime bracing, avoidance of activities that cause the symptoms, such as driving, riding a bike, those types of things. Give your hand a rest. Let the symptoms disappear before beginning the onset of those activities again. Sometimes antiinflammatories and vitamin B6 can be helpful adjuncts to treating carpal tunnel syndrome. Surgical treatment is primarily determined based on the patient’s symptoms. Basically, this is primarily individual patient driven.

If the patient gets satisfactory alleviation of the symptoms by undergoing conservative treatment options, then we stick with that plan of treatment. If the patient continues to have symptoms, particularly if the symptoms are waking them up at night, preventing them from getting a full night’s sleep, and none of the nonsurgical therapeutic measures are helping them with their symptoms, then at that point it’s time to go to surgery, and that’s irrespective of the severity on the electrodiagnostic study. So primarily surgery is determined based on the patient’s symptoms. To a degree it is determined based on.

The electrodiagnostic study as well. Today we’re going to go ahead and look at a surgical case of endoscopic carpal tunnel release. This is a patient who’s had symptoms of carpal tunnel syndrome for some time and she hasn’t gotten any relief with conservative management, so we’ve opted for surgical release, and this one is going to be done endoscopically. This is just a very small opening that we’ll be creating just to get the scope into the area under the wrist. And come in there, Steve. Then just cutting part of the ligament.

Carpal Tunnel Syndrome Part 3 Endoscopic Carpal Tunnel Release

That’s in the forearm here. Now what we do is we open up the carpal canal. Back from the discussion that we had in the office, the canal is generally tight, and we need to insert the probe here, or a dilator, place it into the canal, and we’ll sequentially dilate it with different size dilators. This is the first of the three sizes of the dilator. Next size. Okay, and then final size. This is the widest dilator. Typically the size of the scope that’s going to be inserted. This is a little sled that the camera.

And the knife get inserted into. Okay. Now we’re going to go take a look inside of the canal here with the scope. Put it this way. Through that we’ll be able to see the carpal canal. Now we’re just introducing the camera into the carpal canal. That white band right there is the ligament that we’ll be cutting. That’s right on the top there. Okay. So go ahead and hold that scope there, Steve. This is the probe to feel for the canal. That’s inserted under here. Now we’ve got the probe,.

And slide the camera in a little bit, and it falls in right on the undersurface here on the back side. So that’s going towards the fingers. This here is coming back out towards the palm. Okay. We’re going to place the knife in that same slot as the probe. Now we’re just going to take this knife and cut the ligament here. You can see the separation of the ligament. We’re good there. Slide on in. We’re going to come back through here and kind of complete the cuts. Now you can see everything on the undersurface there,.

The two sides of the leaflets of the canal when they’re pushing through there. One on that side, and this is some of the fatty content falling into the canal from above. Okay, slide the scope on out. We’re going to complete the cut here, and that’s it. And that’s it. So now all it is, is just taking the scope out, washing the wound, and putting a few stitches into the skin. And that’s it. There you go. It was just a small incision, so they can start using their hand right away.

Cut there. Cut there. What we’re left with is a small little incision with some sutures in it. That’s right here at the base of the wrist. Open carpal tunnel would be performed up in here, and that alleviates the discomfort from the incisional site here, placing the incision here for the endoscopic carpal tunnel. Then just a small little protective bandage over the incision. And cut there. Then a small wrap to keep that wrap on. Okay, cut there. That’s what they go home with. That was the procedure for endoscopic carpal tunnel release.

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