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Endoscopic Carpal Tunnel Release (ECTR) refers to a method of performing carpal tunnel surgery using an endoscope or an arthroscopic device. Endoscopic techniques for carpal tunnel release involve one or two smaller incisions (less than half inch each) through which instrumentation is introduced including a synovial elevator, probes, knives, and an endoscope used to visualize the underside of the transverse carpal ligament.〔http://www.youtube.com/watch?v=M4hTY1vyrxg〕 The endoscopic methods do not divide the subcutaneous tissues or the palmar fascia to the same degree as the open method does. Many studies have been done to determine whether perceived benefits of a limited endoscopic or arthroscopic release are significant. Many surgeons have embraced limited incision methods. It is considered to be the procedure of choice for many of these surgeons with respect to idiopathic carpal tunnel syndrome. Supporting this are the results of some of the previously mentioned series that cite no difference in the rate of complications for either method of surgery. Thus, there has been broad support for either surgical procedure using a variety of devices or incisions. ==The procedure== For ECTR or any carpal tunnel release surgery while there are many different blades and techniques the primary goal is to release the transverse carpal ligament (TCL) that overlies and compresses the median nerve within the carpal tunnel. It is this compression on the median nerve that leads to the characteristic 'pins and needles' paresthesia in the thumb, index, long and ring fingers. The primary benefit of endoscopic releases versus traditional open carpal tunnel release is often perceived to be the smaller incision size. ECTR incisions are commonly less than compared to a longitudinal incision with a traditional carpal tunnel release. However, the incision size is not the only factor that differentiates the two methods. The principle behind the endoscopic release is that the Palmar aponeurosis, a thick tough layer of tissue that lines the palm, is not divided with endoscopic methods. In addition, the endoscopic methods offer less dissection and interruption of tissue planes than the open methods because the endoscopic methods do not divide the subcutaneous tissues or the palmar fascia to the same degree as the open method does.〔Agee, JM etal Endoscopic release of the carpal tunnel: A randomized prospective multicenter study |Journal = The Journal of Hand Surgery | Volume=17 | issue=6 |pages=987–995 | http://www.sciencedirect.com/science/article/pii/S0363502309910449〕 Thus, a more rapid recovery is generally touted with ECTR as the normal skin above the TCL is not incised. Surgery, either open or endoscopic is a way to treat Carpal Tunnel Syndrome. A meta-analysis supports the conclusion that endoscopic carpal tunnel release is favored over the open carpal tunnel release in terms of a reduction in scar tenderness and increase in grip and pinch strength at a 12-week follow-up 〔Thoma, Achilleas M.D., M.Sc.; Veltri, Karen M.Sc., Ph.D.; Haines, Ted M.D., M.Sc.; Duku, Eric M.Sc. A Meta-Analysis of Randomized Controlled Trials Comparing Endoscopic and Open Carpal Tunnel Decompression Plastic & Reconstructive Surgery:October 2004 - Volume 114 - Issue 5 - pp 1137-1146〕 The use of an endoscope to release the carpal tunnel was first described in 1989 by Okutsu et al. Here a flexible clear plastic tube was used with a standard endoscope to identify the transverse carpal ligament and release it with a retrograde knife. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Endoscopic carpal tunnel release」の詳細全文を読む スポンサード リンク
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