Which is Better: Open Carpal Tunnel Surgery or Endoscopic

Which is better open carpal tunnel surgery or endoscopic


Dr. Perlmutter and Paul Kelley, PA-C, inform you of the two surgical treatments for carpal tunnel: open carpal tunnel and endoscopic carpal tunnel surgery. They discuss what makes endoscopic surgery for carpal tunnel their preferred method for patient recovery and longevity. 

Paul Kelley: Dr. Perlmutter, when it involves carpal tunnel and carpal tunnel surgery, there are options. We specifically do endoscopically. Whereas a lot of other practitioners in orthopedics will do an open carpal tunnel. Can you clearly delineate the difference in why we do what we do?

Dr. Perlmutter: Sure. I do almost exclusively endoscopic carpal tunnels, and it’s my belief that you get a faster recovery and far less painful recovery. In fact, most patients don’t ever take pain medicine after surgery. And that’s really what our goal is, uh, not what our primary goal is to cure the carpal tunnel. But if we can do so more painlessly, that’s really the trick here.

I drew on my hand where my incisions were for a carpal tunnel release. I don’t know if you can see it clear, but it’s a little black line here and here. And with the endoscopic carpal tunnel release, we make a small incision, put a camera in the hand, look up at the ligament, and cut the ligament from one end to the other. We see it 100% of the time and we see it perfectly. Then we cut only the ligament, but we do not cut through the skin between here. We do not make this incision, which would be the open release. Nor do we cut through the muscle below that.

The pain is less, the strength is greater, and the recovery faster.

Now, it is true that at six months, the results of both are the same, but having had an open carpal tunnel release from my partner, I can tell you that it is six months of discomfort. You had an open one as well.

Paul Kelley: I did. Yes.

Dr. Perlmutter: And you’ve had six months of discomfort.

Paul Kelley: I had a hard recovery from it. Absolutely.

Dr. Perlmutter: And so a faster recovery. I don’t think we’ve ever had a patient that’s had a difficult recovery from an endoscopic carpal tunnel release.

It’s a style and difference, typically, those that have undergone hand fellowship training. Not all of us that have undergone specialty training, like I have, do it endoscopically, but that is the way we do it in our practice.

Paul Kelley: Absolutely. 

Carpal Tunnel Surgery

If you’re having issues with carpal tunnel and it becomes a surgical issue, we’d be glad to assist you as well. Learn about our treatment areas. Please call us at (252)-443-0400 or reach out online to schedule an appointment with our team.