Andrew Yang, MD is a hand surgeon with fellowship training in hand and upper extremity surgery at Rothman/Jefferson. Endoscopic release is performed through one small incision.
Learn more about Andrew Yang, MD and his provider background.
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Endoscopic carpal tunnel release relieves pressure on the median nerve by releasing the transverse carpal ligament. The surgeon uses a small camera through a single small incision at the wrist. Compared with the longer incision used for open release, this approach is intended to leave a smaller scar. The choice of procedure depends on your evaluation and the surgeon's recommendation.
WALANT
WALANT means wide-awake local anesthesia, no tourniquet. With this approach, local anesthetic is used without general anesthesia or sedation. In many cases, patients may not need preoperative fasting or a ride home.
Your instructions depend on the procedure and your health. Follow the specific guidance from the surgical team, including any instructions about food, medication, and transportation.
For many patients, endoscopic release may allow a faster return to work than open release. It may also involve less early pain and permit immediate finger motion as directed. Results vary, and no outcome is guaranteed.
Both procedures release the ligament that presses on the median nerve. The differences below describe the general approaches; your surgeon can explain which option fits your situation.
| Feature | Endoscopic release | Open release |
|---|---|---|
| Access | A small camera guides the release through one small incision. | The ligament is reached through an incision in the palm. |
| Scar location | The incision is generally at the wrist and is intended to leave a smaller scar. | The incision is in the palm; length depends on the surgical plan. |
| Recovery | Return to work and activity varies; some patients may resume sooner. | Return to work and activity varies by patient and job demands. |
| Choosing an approach | Both approaches aim to relieve pressure on the median nerve. Examination findings, health history, and the surgeon's assessment guide the choice. | |
Endoscopic release may be considered when an evaluation supports carpal tunnel syndrome and symptoms or nerve findings indicate that surgery may help. It may be discussed when non-surgical care has not provided enough relief or when testing and examination show significant nerve compression.
Not everyone is a candidate for endoscopic release. Your surgeon considers your symptoms, examination, test results when needed, health history, and preferences before discussing surgical options.
STEP 1
The team reviews your medical history, confirms the plan, and gives instructions about food, medications, and transportation.
STEP 2
If WALANT is planned, local anesthetic is used without general anesthesia or sedation. The team will confirm the anesthesia plan with you.
STEP 3
The surgeon uses a small camera and instruments through one small incision to release the transverse carpal ligament.
STEP 4
You receive dressing and activity instructions. Finger motion may begin immediately as directed; the team will explain follow-up and when to call.
This is a general guide, not a promise of a specific recovery time. Individual results vary.
Keep the hand elevated when advised, follow dressing and wound-care instructions, and move the fingers as directed. Discomfort and swelling vary.
Follow up as scheduled and progress light hand use according to your surgeon's instructions. Avoid activities that strain the incision until cleared.
Gradually increase activity based on symptoms, healing, and work demands. Ask the care team before returning to heavy gripping or strenuous tasks.
Strength, comfort, and scar sensitivity can continue to change. Individual recovery varies; follow-up helps guide ongoing activity.
It is a procedure that releases the transverse carpal ligament to reduce pressure on the median nerve. A small camera and instruments are used through a small incision.
Both approaches release the transverse carpal ligament. Endoscopic release uses a camera through a small incision, while open release uses an incision in the palm. The appropriate approach depends on the patient's condition and the surgeon's assessment.
When WALANT (wide-awake local anesthesia, no tourniquet) is used, local anesthetic is used without general anesthesia or sedation. In many cases, patients may not need preoperative fasting or a ride, but they should follow the instructions provided for their procedure.
Endoscopic release may be discussed when an evaluation supports carpal tunnel syndrome and symptoms or nerve findings warrant surgery, including when non-surgical care has not helped enough. Not everyone is a candidate; the recommendation depends on the examination, testing when needed, health history, and treatment goals.
The care team reviews the plan and prepares the hand. With WALANT, local anesthetic is placed around the treatment area without general anesthesia or sedation. The surgeon performs the release through a small incision, then provides dressing and aftercare instructions. The exact plan varies by patient.
Pain and tenderness vary. Many patients may have less early pain and may begin moving their fingers immediately as instructed. Follow the care team's guidance about hand use and activity.
Recovery is individual. The page's timeline is a general guide; symptoms, work demands, health, and healing affect when activities can be resumed. Your surgeon will give instructions based on your progress.
Possible risks include bleeding, infection, scar tenderness, temporary discomfort, nerve or blood-vessel injury, incomplete symptom relief, or additional treatment. Ask your surgeon about risks specific to your health and procedure.
Request an appointment with Andrew Yang, MD or call the office to discuss a carpal tunnel evaluation.
Monday, Wednesday and Friday, 9:00 AM–5:00 PM
Tuesday, 9:00 AM–5:00 PM