Carpal Tunnel Release Surgery is performed for a condition known as Carpal Tunnel Syndrome. The condition occurs with pain on the wrist, thumb and palm. Generally, the condition has been associated with lifestyle occupations and situations where someone uses the wrists for a majority of the daily work. Repetitive motion on this part of the body like in computer-based desk jobs is generally a unified notion for a reason for the occurrence of carpal tunnel syndrome. But, studies have proved that this may not be the only scenario where the condition can occur. Overuse of the wrists and palm for daily work, previous injuries, use of heavy machinery or heavy manual tools or even hereditary reasons may also give way to the condition at some point in life.
How Carpal Tunnel Syndrome affects
A median nerve runs through the lower wrists towards the palm. This nerve aids in the movement of the hand and fingers. This passes through a passage in the wrist called the carpal tunnel. A ligament known as Transverse Carpal Ligament covers the carpal tunnel in the wrist. During injury or excessive force or use leading to injury, swelling occurs that lead to pressing of the median nerve. The space under the ligament during swelling is blocked. This may lead to continued pain, swelling and numbness to the thumb or palm. If not treated, the numbness and radiating pain may increase over time and in extreme cases may result in loss of functions of the palm and fingers too.
Sustained pain, numbness, swelling and lack of normal functions of the palm or fingers are the pointing factors towards a decision on the kind of interventional procedures to be taken by the doctor. In some cases, non-surgical interventions may provide a desired outcome and relief. Therapies, medicines, splints on the wrists and the palm, or even changes to the working conditions and environment may help in relieving the conditions in some scenarios. But if symptoms along with pain continue for a long, the doctor may prescribe carpal tunnel surgery as a remedial intervention. The surgery can be performed in either of the two ways- Open Carpal Tunnel Release or Endoscopic Carpal Tunnel Release.
In the Open Carpal Tunnel Release method the surgeon does the procedure by a conventional method of cutting the wrist open and performing the surgery of releasing the tunnel. This is done by cutting the Transverse Carpal Ligament from above, directly.
But in Endoscopic Carpal Tunnel surgery, the surgeon does not need to go for a large incision or cutting of the wrists in the conventional method.
The Endoscopic Carpal Tunnel Surgery- procedure
In this method, the surgeon is guided by an endoscope. The endoscope has a tiny camera at the end of the tube which would help capture the images as it moves inside the carpal tunnel. The output would be cast on a video output screen for the surgeon to observe. The surgery is performed via a single-portal method wherein only a single small incision is made at the wrist. The endoscope is guided through this incision into the tunnel. It also helps in moving the cutting tool to the affected area. Once in place, the surgeon makes a cut on the Transverse Carpal Ligament that will release the pressure on the median nerve which can now be free from the force and swelling on it. Once the endoscope and cutting tool is removed the incision is closed with stitches.
After the procedure
The immediate period of recovery at the hospital is short. Normally a daycare procedure, the patient is discharged on the same day or the next day. The recuperation period can be for months. The pain or numbness may sustain from a day to months in varied levels. In some cases, the pain subsides gradually after a few days.
The wrist will be covered in a bandage or placed in a splint for a couple of weeks for the healing to take place. The patient must undergo physical therapy for some time to help the wrist and the fingers to get accustomed to the change and get back to the normal strength.
The patient is advised not to take up heavy work or work involving lifting of weights, use of heavy machinery or heavy manual labour involving hands for some period- generally 4-6 months. Normal work can be resumed after 6-8 weeks post-surgery.