Carpal Tunnel Surgery Using a Wireless Endoscopic Visualization Instrument: A Cadaveric Study

Background: Endoscopic carpal tunnel release is a common treatment for moderate to severe carpal tunnel syndrome. Recently there have been various new techniques which offer improved accuracy and decreased recovery time. In this study, orthopedic surgeons and biomedical engineers from the Faculty of Medicine and Faculty of Engineering, Prince of Songkla University, designed a wireless endoscopic carpal tunnel release with a single portal technique and tested the efficacy and safety of the new technique in a cadaveric study. Methods: Ten fresh cadaveric forearms were used in the study. The surgical technique began with a surgical incision 15-20 mm above the wrist crease on the line between the middle finger and ring finger. The palmaris longus aponeurosis was retracted by Senn retractors. A visual enhancer was inserted to improve the internal visual field in order to see the flexor retinaculum clearly. The flexor retinaculum was cut distally to create an entry and the flexor retinaculum was cut by the scalpel. The flexor retinaculum length was observed until the release was completed. The median nerve was observed. Results: Each flexor retinaculum was cut completely. All of the median nerves were carefully observed during the operation and none were injured. This technique showed the effectiveness and safety of minimally invasive carpal tunnel surgery. Conclusions: The study found that the new device using this technique is effective for carpal tunnel syndrome (CTS) surgery in terms of minimally invasive endoscopic carpal tunnel surgery.