Prima Medical Group

Raymond Bonneau, M.D. Orthopedic Surgeon

165 Rowland Way, Suite 100
Novato, CA 94945
(415) 898-4211
www.primamedgroup.com

Endoscopic Carpal Tunnel Release Information

Introduction

You have been scheduled for an endoscopic carpal tunnel release. This has now become the most common way to perform carpal tunnel surgery, as it is far less invasive and painful than open surgery.

Pre-Operative Instructions

You should not take Motrin, Advil, Naprosyn, or any other nonsteroidal anti-inflammatories for ten days prior to surgery. You should not take aspirin for ten days prior to surgery unless you have had any type of cardiac surgery including angioplasty, stent placement or bypass then you will need to continue taking aspirin, unless otherwise instructed by your cardiologist. You may eat or drink anything you’d like the night before the surgery, but you should have no solid food after midnight the day of your surgery. You may have clear liquids up until 4 hours before your surgery but limited to 4 ounces. Clear liquids are fluids that light can shine through, such as apple juice, coffee, tea and water. This does not include orange juice or milk. The best thing to have is a glass of apple juice or cranberry juice approximately 6 hours before the surgery to give you some glucose and fluids to get by until the time of surgery. Please make sure you drink nothing, not even water, beginning 4 hours before surgery.

Going to the Hospital

You should report to North Bay Regional Surgery Center or Novato Community Hospital 1 to 1 ½ hours prior to the scheduled time of your surgery. If your surgery is in the afternoon, it is often a good idea to call Same Day Surgery 4 hours before your surgery to determine whether or not the surgical schedule is running on time. The number at North Bay Regional Surgery Center is 415-209-2500. The number at Novato Community Hospital is 415-209-1558.

Anesthesia

You will get to speak to your anesthesiologist prior to the surgery. For endoscopic carpal tunnel release, we usually use a general anesthetic. The procedure is very brief and with the modern general anesthetic for this short procedure, post-operative nausea is quite rare.

Surgery

The procedure itself takes approximately 15 minutes, and you’ll usually be in the operating room about one-half hour. The procedure is performed through a small 1/4 to 1/2 inch incision in your wrist crease. Through this portal, the endoscopic carpal tunnel release system is introduced and used to divide the transverse carpal ligament, which is the ligament overlying the carpal tunnel that is pressing on the medial nerve and causing the numbness in your hand. After the ligament is released, the devise is removed and local anesthetic is placed in the area, and the wound is closed with two nylon sutures. A bandage with an ace wrap is placed on your hand, but your fingers will be out and somewhat usable.

Post-Surgery

After the surgery, you will wake up in the recovery room with an ace bandage on your hand, and your hand and fingers will be completely numb. You’ll usually stay in the recovery room for approximately 30 minutes, following which you’ll return to Surgical Day Care for an hour or so, until you feel well and can go home.

At home

The local anesthetic will last 6 to 8 hours, following which you’ll have a feeling of bruising or soreness in your palm. Don’t hesitate to take the pain medication as we certainly want you to be as comfortable as possible. This period of bruising or soreness may last for 3 to 4 days, and then will begin to gradually resolve. You may notice some bleeding on the bandage, which is normal and you should not be concerned. If the bandage becomes quite soaked, however, you can certainly come to the office and we can change the bandage for your comfort.

We would normally see you back in the office 2 to 4 days following your surgery. At that point we’ll remove your bandage and sutures, and place a band-aid on the wound. After this time, you’ll be able to take a shower. Gently dry the wound and place new band-aids over the wound. We would suggest you not put any ointments, such as Neosporin on the wound, and do not immerse your hand in water, such as a bathtub or a hot tub, for 10 days following the surgery. After 10 days, the band-aid will be discontinued and you can immerse your hand in water.

By 3 weeks, most patients note that the majority of the soreness has resolved and they can return to most of their day to day activities. It may take 6 weeks or more before you can do heavy work with your hand. Most people report it takes 3 months for all of their soreness to resolve.

Much of the burning and tingling in your hand, the type that may awaken you at night, will usually resolve in 3 weeks. However, full recovery of the nerve requires regeneration of nerve fibers from the area of the carpal tunnel at the base of your palm, out to the tips of your fingers. As nerves grow only approximately 1 inch per month, it will often require 6 to 12 months for complete recovery of all neurological function.