Abstract
Background A large variety of endoscopic carpal tunnel release methods have been described in
efforts to shorten recovery time, reduce scar discomfort, and allow earlier return
to work. The majority of existing techniques are the modifications of the Agee, Chow,
and Menon techniques, all of which require dedicated equipment that can increase facility
and surgical fees for the patient and institution. We present a novel high-visibility
endoscopic carpal tunnel release technique that uses common hand surgery instruments
available in all surgical units, without requiring disposable or custom devices.
Description of Technique The cases were performed under local anesthesia using routine reusable instruments
and a conventional 2.5-mm 30-degree small joint arthroscope. Following proximal dissection,
a clear, colorless, plastic shield was created from a standard syringe that offered
a 360-degree vision of the carpal tunnel and protection of the median nerve. Release
of the transverse carpal ligament was performed under full arthroscopic vision using
Metzenbaum dissection scissors.
Methods This pilot study analyses the first nine cases in eight patients who were operated
on using this technique, with a minimum of 6 months of follow-up.
Results No peri- or postoperative complications were encountered. All patients demonstrated
significant improvements in the Disabilities of the Arm, Shoulder, and Hand score,
the Boston Carpal Tunnel Questionnaire score, and a visual analog score for pain.
Conclusion The high-visibility endoscopic carpal tunnel release technique is safe and effective,
and offers a viable cost-reducing alternative to the existing endoscopic methods for
carpal tunnel syndrome. Future comparative trials are required to validate these findings
in a larger series.
Level of Evidence This is a Level IV study.
Keywords
carpal tunnel - endoscopic carpal tunnel release - median nerve - nerve compression
- peripheral neuropathy - cost reduction
