Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series

J Hand Surg Eur Vol. 2015 Feb;40(2):193-8. doi: 10.1177/1753193414524688. Epub 2014 Feb 25.

Abstract

Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques.

Keywords: Supraretinacular endoscopic carpal tunnel release.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / surgery*
  • Dissection
  • Endoscopy
  • Female
  • Humans
  • Ligaments / surgery*
  • Male
  • Median Nerve / surgery
  • Middle Aged
  • Prospective Studies
  • Ulnar Nerve / surgery