Endoscopic carpal tunnel release surgery: Report of patient satisfaction

Recently, a trend has developed to use an endoscope to achieve carpal tunne l release. Proponents of the endoscopic technique believe it has benefits t o patients that include minimal incision, minimal pain and scarring, a shor tened recovery period and a high level of patient satisfaction. To test the se beliefs, a retrospective analysis of the first 42 cases that were done b etween May 1997 and June 1998 was completed. Endoscopic carpal tunnel relea se surgery was performed on patients with the classical clinical and neurop hysiological findings of carpal tunnel syndrome. The procedure was performe d in an outpatient surgery center under primarily local anesthesia and by t he same neurosurgeon (RG), who was blind to data analysis. The biportal tec hnique (Instratek Inc., Houston, TX, USA) was used as described by Brown. T he first 42 patients (n = 35, seven patients had bilateral surgeries) were sent a survey (modified Health Outcomes Carpal Tunnel Questionnaire, Health Outcomes, Bloomington, MN, USA) that measured a wide spectrum of variables , with a year follow-up. Patient demography indicated wide patient selectio n. All subjects (100%) had claimed work-related injury Patient satisfaction was reported in 86%. No or mild incisional pain, night pain, absent tingli ng, and improved grip strengthening were reported in 100%, 95%, 81%, and 85 % respectively. The mean for return to daily activity and work was 14 and 2 5 days respectively. No recurrent hematoma, infection, or structure injury was reported. Endoscopic carpel tunnel release on he done safely and effect ively with excellent self-reports of patient satisfaction. Reduced recovery period and hospitalization with minimal tissue violation and incisional pa in can be expected.