Carpal tunnel syndrome (CTS) begins with numbness and tingling in the hand and progresses weakness of thumb and clumsiness in holding objects. . It is a very common condition that is caused by pressure on nerve in the palm of the hand. The symptoms may occur intermittently during the daytime and sometimes occur at night and one may wake from sleep because of pain/discomfort. Repetitive motions typically cause carpal tunnel syndrome. Any activity that involves grasping, squeezing or clipping motions such as using a computer, using power tools, knitting or playing the piano can result in carpal. Initially one can treat carpal tunnel syndrome with splint and medications. Later on surgery is recommended to avoid permanent changes to occur because of long standing pressure on the nerve.
Pressure on the nerve is relieved by releasing ligament (transverse carpal ligament) which covers the carpal tunnel through which nerve passes. In standard open carpal tunnel release 2-3 inch incision in palm and wrist is given, one of the major draw backs to this is the slowness of recovery in the palm side surgical scar. Often, the 2 inch palm side scar would remain sensitive to direct pressure for approximately six to eight weeks or sometimes more. In the working patient, this scar sensitivity could preclude return to normal work activities. Especially in Indian housewives many times when they are working with roller pin (belan) in kitchen they experience pain. Therefore endoscopic release in which less than half inch incision is required in forearm heals well. Endoscopic carpal tunnel release is a highly technical procedure and is best performed by a surgeon, who performs this surgery often. Such a surgeon can maximize the benefit and minimize the risks. It is a 15-20 minutes operation which requires special instruments. Patients are allowed to move their hand and wrist immediately after surgery. The surgery is out patient surgery so the patient goes home the same day as the surgery. Dr Vikas Gupta has one of the highest series of these type if surgeries in the country. He also performs wrist arthroscopy and endoscopic cubital tunnel release. He is the only surgeon in India who is performing endoscopic carpal tunnel release by both Menon’s technique as well as Agee’s technique