Endoscopic Carpal Tunnel Release Past, Present, and Future Directions

Carpal tunnel release is a safe and reliable option for the surgical treatment of carpal tunnel syndrome. It has traditionally been performed under direct visualization through an open approach. Endoscopic carpal tunnel release (ECTR) was developed as a minimally invasive alternative with the goals of decreasing soft tissue trauma and accelerating functional recovery. Endoscopic carpal tunnel release continues to increase in popularity from both a surgeon and patient perspective. Endoscopic carpal tunnel release has been shown to result in earlier functional improvement compared to traditional open techniques but with no meaningful differences in long-term outcomes. The cost-effectiveness of ECTR remains unclear. This review highlights the history of ECTR, the current literature regarding outcomes and cost, and the future directions of carpal tunnel surgery.