Specialty Surgeon Complete Packaged Procedure for a Endoscopic Carpal Tunnel Release. Endoscopic Carpal Tunnel Release is occasionally done using a general anesthetic (one that puts you to sleep). More often, a regional anesthetic is used. A regional anesthetic blocks the nerves going to only a portion of the body. Injection of medications similar to lidocaine are used to block the nerves for several hours. This type of anesthesia could be an axillary block (only the arm is asleep) or a wrist block (only the hand is asleep). The surgery can also be performed by simply injecting lidocaine around the area of the incision.
Once you have anesthesia, your surgeon will make sure the skin of your palm is free of infection by cleaning the skin with a germ-killing solution. The surgeon nicks the skin to create a small opening just below the crease in the wrist where the palm starts. This opening allows the surgeon to place the endoscope into the carpal tunnel. Some surgeons make a second small incision within the palm of the hand. The procedure using a single incision is becoming more popular. The incision allows the surgeon to open the carpal tunnel just below the carpal ligament. Once the surgeon is sure that the instruments can be passed into the carpal tunnel, a metal or plastic cannula (a tube with a slot on the side) is placed alongside the median nerve. The endoscope can be placed into the tube to look at the underside of the carpal ligament, making sure that the nerves and arteries are safely out of the way. A special knife is inserted through the cannula. This knife has a hook on the end that cuts backwards when the knife is pulled back out of the cannula. Once the knife is pulled all the way back, the carpal ligament is divided, without cutting the palmar fascia or the skin of the palm. Once the carpal ligament is divided, the median nerve is no longer compressed and begins to return to normal. After the carpal ligament is released, the surgeon stitches just the skin openings and leaves the loose ends of the carpal ligament separated. The loose ends are left apart to keep pressure off the median nerve. Eventually, the gap between the two ends of the ligament fills in with scar tissue.
Endoscopic Carpal Tunnel Release treatment cost includes the facility fee, physician’s fee, bracing (if needed), cost of drugs and any related medical procedures required to administer the plan of care. Not included are diagnostic studies, Medication Prescription costs, consultations with additional specialists and cost of complication management; travel, food and lodging.