Introduction
Carpal Tunnel Surgery is a critical procedure designed to alleviate the symptoms of Carpal Tunnel Syndrome (CTS) by releasing pressure on the median nerve. Understanding what happens during the surgery can help alleviate anxiety and prepare patients for what to expect. This detailed blog post explores the surgical techniques and processes involved in Carpal Tunnel Surgery.
Understanding Carpal Tunnel Surgery
Carpal Tunnel Surgery, also known as carpal tunnel release or carpal tunnel decompression, aims to relieve pressure on the median nerve located within the carpal tunnel of the wrist. This is achieved by severing the transverse carpal ligament that forms the roof of the tunnel, thus enlarging the tunnel and decreasing pressure on the median nerve. The procedure itself takes around 20 minutes, although extra time is needed for pre-operative assessment, administration of local anaesthesia and the positioning and preparation of patient for surgery.
Surgical Options
- Open Carpal Tunnel Release: This traditional method involves a two- to three-centimetre incision in the palm of the hand, allowing the surgeon direct access to cut the transverse carpal ligament.
- Endoscopic Carpal Tunnel Release: A minimally invasive technique where the surgeon makes one or two small incisions (about half a centimetre each) in the wrist and possibly the palm. A tiny camera (endoscope) is inserted into one of the incisions to guide the surgeon in cutting the ligament.
Preparation for Surgery
- Anaesthesia: Most Carpal Tunnel Surgeries are performed under local anaesthesia, which is an injection that numbs the hand and wrist area but leaves the patient awake and alert. Sometimes, sedation or regional anaesthesia (which numbs the entire arm) is used.
- Positioning: The patient’s arm is positioned, cleaned, and draped to maintain sterility throughout the procedure.
Step-by-Step Surgical Process
- 1. Incision: In open surgery, the surgeon makes an incision in the palm, while in endoscopic surgery, the incision(s) are smaller and made at the wrist.
- 2. Viewing and Accessing the Carpal Tunnel: In open surgery, the surgeon directly views the carpal tunnel; in endoscopic surgery, this is done via the camera on the endoscope.
- 3. Cutting the Ligament: The transverse carpal ligament (the roof of the carpal tubnnel) is carefully cut to release pressure on the median nerve. This is the critical step of the surgery.
- 4. Closure: The incision is then sutured, and a dressing and bulky bandage is applied.
What to Expect Immediately After Surgery:
- Observation
- After a short observation period, patients are able to leave straight away if local anaesthetic was used for the surgery.
Post-operative Care
- Pain Management: Patients will take simple over the counter pain medication to manage discomfort in the days following surgery. In some patients, stronger prescription painkillers may need to be prescribed.
- Wound Care: Instructions on how to care for the surgical site will be provided, including how to keep it clean and dry.
- Rehabilitation: Rehabilitation starts with gentle hand movements to decrease stiffness and improve circulation.
Long-Term Recovery
- Follow-Up Visits: Scheduled to monitor the healing process, remove stitches, and assess any complications.
- Physiotherapy: Often recommended to restore strength and flexibility to the wrist and hand.
- Recovery Time: Complete recovery and a return to normal activities can vary but typically occur within several weeks to months, depending on the individual’s health status and the nature of their work.
Conclusion
Carpal Tunnel Surgery is a highly effective procedure for relieving the symptoms of CTS. Understanding the surgical process helps patients prepare mentally and physically for the operation and recovery. At Excel Clinic, we ensure our patients are fully informed and supported throughout their surgical experience, from initial consultation to full recovery.
