Endoscopic carpal surgery in carpal tunnel syndrome: A systematic review

Abstract

Objective: Endoscopic carpal tunnel release has become increasingly popular and has shown the advantage of early recovery of hand function with minimal morbidity. In this systematic review, we aimed to summarize the currently available data and describe the reported advantages and disadvantages of endoscopic carpal tunnel surgery for treating carpal tunnel syndrome. Methods: In this study, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, which is a set of reporting requirements for systematic reviews and meta-analyses. The search strategy with MeSH terms was “MeSH (carpal tunnel syndrome) AND (endoscopic)” Filters: in the last 5 years, English—on February 27th, 2022. A total of 131 articles fulfilled the first screening criteria. A detailed analysis of those articles identified 39 that matched the criteria, of which 14 were considered appropriate for this analysis after applying the complete inclusion and exclusion criteria. Results: A total of 14 studies met the eligibility criteria. Analysis of those studies found that all types of portals in endoscopic carpal tunnel release reduced postoperative pain at a short-term follow-up. There was no evidence to suggest the superiority of the single- or two-portal techniques in terms of outcomes. In terms of pain relief, symptom resolution, patient satisfaction, duration to return to work, and adverse events, this early use of endoscopic carpal tunnel release produced satisfactory outcomes. Further studies comparing the number of portals are needed. Conclusion: Endoscopic carpal tunnel surgery for treating carpal tunnel syndrome is effective and both single- and dual-portal techniques provide advantages in terms of early recovery and minimal morbidity.

The First National Survey of Endoscopic Plastic Surgery by the Japan Society of Plastic and Reconstructive Surgery 2020-2021

“…In this nationwide survey in Japan, more than 50 cases were reported in pectus excavatum surgery, carpal tunnel release, craniomaxillofacial tumor excision, facial fracture repair, breast augmentation, and breast reconstruction. Among these, the pectus excavatum and carpal tunnel release procedures are acknowledged as enhancing surgical safety with endoscopic support, and the approaches for these procedures are well established 10,11) . The others are areas where skin scarring should be minimized as much as possible, such as the face and breast, and where the advantages of endoscopic surgery can be exploited.…”

Surgical Interventions for the Management of Carpal Tunnel Syndrome: A Narrative Review

“…As pain is one of the postoperative outcomes, a study conducted by Schroeder et al in 2022 on 1,125 patients with CTS who underwent open and endoscopic surgery found that postoperative opioid use was similar in both groups [ 32 ]. In a study conducted by Liawrungrueang et al in 2022, they found a decrease in short-term pain in the ECTR in a follow-up period extended to two weeks [ 33 ]. Modified ECTR showed a significantly shorter operation time of 33.57 ± 4.21 minutes but no difference in relieving scar pain during the follow-up period [ 29 ].…”