Many people have anxiety about going under the knife and being stitched back up again. Others are reluctant, understandably so, to treat their carpal tunnel, tennis elbow, or arthritis of the hand because of the scars that will be left by the incisions and stitches. Both of these reservations are valid, and both of these reservations are not an issue with the Endoscopic No-Stitch Technique to treat carpal tunnel syndrome (CTS).
The idea of having hand surgery without stitches sounds great. Hand surgery with no large incision sounds almost too good to be true. The fact is that this type of surgery does exist, and it is performed by orthopedic hand surgeons every day.
What is the Endoscopic No-Stitch Technique?
The Endoscopic No-Stitch Technique is exactly what it sounds like; a surgical technique that leaves neither any noticeable incision nor stitches, and therefore, no scars. This is accomplished by using an endoscope. An endoscope is a thin, flexible tube, outfitted with small LED lights and a camera that is connected to a monitor for the surgeon to see what is going on.
How Does It Work?
For the treatment of CTS, the affected hand will be numbed with a local anesthetic. Then, a tiny incision just above the wrist is made on the palm.
Next, the hand doctor will insert the endoscope. Once the endoscope is inserted through the tiny incision, it will guide the hand surgeon to the transverse carpal ligament. The ligament is cut because the carpal tunnel is too narrow for the median nerve to glide through.
By cutting the ligament, the carpal “tunnel” becomes more of a “canal,” that provides enough room for the nerve to pass without any friction to inflame the surrounding tissues.
After severing the transverse carpal ligament, the surgery is basically complete. All that’s left for the surgeon to do is remove the endoscope and give instructions for how to care for your hand during your brief recovery.
What Does Traditional Open Surgery Entail?
In traditional open CTS surgery, a hand surgeon will make a large incision at the base of the palm of the hand to get to the transverse carpal ligament.
The ligament is cut, the skin is placed back over the incision, then stitched back up. The gap where the transverse carpal ligament was cut will eventually fill in with scar tissue over time.
What Can Be Expected Post-Procedure?
Relief is almost immediate with either an open or endoscopic procedure. The stitches in a traditional open operation will be ready to come out 10 to 14 days after surgery.
Once the stitches come out, heavy hand use must be restricted for up to 3 months. Then, of course, there will be unavoidable scarring from the incision and subsequent stitches.
With an endoscopic carpal tunnel release, there is no incision to stitch back up. Relief, again, is almost instant after surgery. The tiny incision will be covered with steri-strips that can be removed usually less than two weeks after the surgery.