The minimally invasive endoscopic carpal tunnel release, also known as the No-Stitch procedure, is our Houston hand specialist’s preferred method for treating carpal tunnel syndrome. It takes less than ten minutes and involves such a tiny incision that a steri-strip is all that is needed to cover the incisions.
We are proud of our 98 percent success rate in alleviating symptoms with minimal recovery time, no complications, and sustained results.
- Stitchless, minimally invasive outpatient procedure
- Typically 10 minutes in duration
- Immediate relief from nighttime pain
- Minimal recovery time (typically, three weeks to normal activity)
- 98 percent surgical success rate
Diagnosis of Carpal Tunnel Syndrome
Carpal tunnel syndrome is diagnosed based on patient history (symptoms), physical examination, and testing. Individual symptoms can be misleading, so a combination of these three are important in making a proper diagnosis. Physical tests you can expect to undergo include the following:
- Tinel’s test: tapping over the median nerve to elicit a tingling or shock in the fingers.
- Carpal Tunnel Compression Test: holding pressure on the median nerve, causing increased numbness to the fingers served by the median nerve.
- Phalen’s Test: flexing the wrist at a 90-degree angle to reproduce numbness in the fingers.
- EMG/NCV (electromyogram/nerve conduction velocity) Test: detects possible nerve damage in the wrist and fingers that may result from carpal tunnel syndrome.
- MRI, ultrasound and diagnostic steroid injections are sometimes employed.
The No-Stitch procedure begins with two tiny incisions, through which a small endoscope with a camera is threaded into the palm of the hand. With a tiny scalpel, the surgeon enlarges the “tunnel” by cutting through part of the transverse carpal ligament that forms its roof.
Nighttime pain should go away immediately. Numbness and tingling of the fingers can persist up to three months, but should steadily improve over that period.
Because the incisions are so small, they heal quickly. The patient should keep the hands dry as long as it takes for the steri-strips fall off naturally, after which the patient can shower or wash hands as usual. Avoid submerging hands through bathing, swimming, or doing dishes for two weeks post-surgery, and avoid fishing for three weeks.
After two weeks, patients may soak their hands in warm water with a scoop of epsom salt for 10 minutes in the morning and again in the evening to help with inflammation and promote healing. The arm should be kept elevated as much as possible to discourage swelling. Take prescribed pain medications only if needed, and restrict lifting to five pounds or less for a full three weeks.
Note: A very small percentage of patients (less than .5 percent) with carpal tunnel syndrome cannot have an endoscopic No-Stitch procedure because of abnormal anatomy. If this is the case, our surgeons perform a traditional open procedure.