Endoscopic Carpal Tunnel Decompression

What you should know

• You may need endoscopic surgery for your carpal tunnel syndrome (CTS). Carpal tunnel syndrome is a disorder where a nerve in your wrist is compressed (pressed in). When you have CTS, may have a pins-and-needles feeling in your wrist and hands. You will have pain or numbness in at least 2 fingers, including your thumb, index, or middle finger. At night, you may wake up with pain or weakness in your hand or wrist. You may have CTS because you use your wrist in the same way again and again. Diseases like arthritis or diabetes may also cause CTS. Your caregiver may suggest endoscopic carpal tunnel surgery (ECTS) if other treatments do not work for you.
  
  
• ECTS is a closed surgery, which means that your caregiver will do the surgery from inside your wrist. That way, your caregiver does not have to cut down into your wrist. Instead, he uses an endoscope that has a camera to help him see inside your wrist. The carpal ligament is a band of tissue that connects joints in your wrist. Cutting this ligament decreases the pressure on the nerves in your wrist. Having an ECTS may improve your symptoms and help you to function better. ECTS may improve the strength of your grip and your pinch. It may also decrease your time off from work due to pain and weakness caused by CTS.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• Your hand may get an infection or get a bruise under the skin. The pain in your hand may not go away or may come back. Your scars may be painful and your finger may become stuck in a bent position. During the surgery, your caregiver may decide that he needs to make a larger cut. You may bleed more than expected. A tendon (strong tissue that connects muscles to bones), nerve, or blood vessel may be cut. If a nerve is cut, you may have long-term numbness or weakness in your index finger or thumb. You may need another surgery to correct some of these problems.
  
  
• If you do not have surgery, the pain in your hand may get worse. Your hand may feel more weakness or numbness. You may have a hard time using your hand when this happens. You may not be able to work or do things you normally do. You may stop being able to feel things on your wrist. You also may no longer be able to move your wrist. Call your caregiver if you have questions about your medicine, condition, or care.

Getting Ready

Before your surgery:

• Ask someone to drive you home when you are ready to leave the hospital. Do not drive yourself home.
  
  
• Your caregiver may do an x-ray to check the bone structure in your wrist and hand.
  
  
• Write down the date, time, and location of each test.

The night before your surgery:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

• Your hand will be placed on a special table, cleaned, and covered with a sheet. Your caregiver will give you anesthesia medicine to help decrease the pain during your surgery. You may be given local anesthesia to numb your wrist and hand. You may also get regional anesthesia that numbs your arm or general anesthesia to keep you completely asleep. A cuff called a tourniquet may be put around your upper arm to decrease bleeding during your surgery.
  
  
• Your caregiver will make one or two cuts on your wrist or palm. He will insert the endoscope with the camera to help guide him during surgery. Special tools may be put in your wrist to help protect the nerves. He will use scissors or a knife to cut the ligament that is pressing on the nerve. The cut will be closed with stitches and covered with bandages. Your caregiver will then take off the tourniquet.

After your surgery:

You will stay in a room until you wake up or gain feeling in your arm. Do not try to get out of bed until your caregiver says it is OK. Your caregiver will tell you when it is time to go home. You will be asked to move your fingers soon after your surgery. A splint will be put on your wrist to keep the wrist from twisting or bending.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your surgery.
  
  
• You get sick (a cold or flu).
  
  
• The pain in your hand becomes worse.
  
  
• You have a fever.

Seek Care Immediately if

• You cannot feel or move your wrist or hand.
  
  
• You feel a lump on your wrist.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.