Historically, carpal tunnel surgery is not a procedure with the easiest recovery. The period of post-surgery healing can be monotonous and painful.
“Patients used to try and put off the surgery for as long as possible because of the downtime, time off work, and pain,” says Timothy Harman, DO, CAQ, assistant director of the Hand Surgery Fellowship through Grandview Medical Center, who has been performing the surgery for more than a decade.
Dr. Harman and two other network surgeons, Elizabeth Dulaney-Cripe, MD, and Krista Migliore, DO, sought further training on a minimally invasive, endoscopic surgery for carpal tunnel to give patients another option.
Carpal tunnel syndrome is the most common pinched nerve in the wrist. “We see it a lot in the diabetic population and anyone who has hypothyroidism,” says Dr. Dulaney-Cripe, an orthopedic surgeon at Far Oaks Orthopedics. “Any time people do repetitive lifting or grasping, or anyone who has vibration in the materials they work with, they are at risk for carpal tunnel.”
According to Dr. Harman, to cure carpal tunnel, the ligament needs to be surgically released to open up space around the pinched nerve and create a larger tunnel space. Historically, this was done by creating a six- to seven-inch incision across the palm and wrist. The evolved procedure uses a smaller, five-millimeter incision made in the crease of the wrist just below the palm.
From there, a camera is inserted through the incision to aid the surgeon in visualizing and releasing the ligament. The entire surgery takes approximately three minutes to complete.
Among the many benefits of this procedure is less pain during the healing process. According to Dr. Dulaney-Cripe, the skin on the forearm heals much faster than the skin on the palm, allowing patients to return to work more quickly and participate in more activities a bit earlier.
Dr. Harman also points out that this approach is economical for patients who require carpal tunnel repair on each wrist, as they can both be operated on in one surgical setting, meaning simultaneous recovery and the patient only undergoes an anesthesia event one time.
“It’s one of my favorite surgeries t do because it really impacts the patients,” Dr. Harman says. “Many times, patients will say it was so easy they wish they would have done it years prior.”
Most patients in need of carpal tunnel surgery are candidates for this surgery, making its benefits widely available.
“When the procedure was first performed, it was only for people’s initial carpal tunnel repair,” Dr. Dulaney-Crpe says. “Carpal tunnel can sometimes come back. It has recently been discovered that you can use it for revision procedures as well.”
Other benefits of the procedure include a lower infection rate and no need for physical therapy or protective splints.
“I started using this approach for the quick recovery time, and then I saw all of the other benefits,” Dr. Dulaney-Cripe says. “It really expands the options for patients.”
To learn more, visit our orthopedics website.
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