Surgical Release Procedure
Limited evidence supports that if surgery is chosen, a practitioner might consider using endoscopic carpal tunnel release based on possible short term benefits.

Rationale
Eleven high quality (Atroshi 2006, Atroshi 2009, Ejiri 2012, Kang 2013, Larsen  2013, MacDermid 2003, Malhotra 2007, Saw 2003, Sennwald 1995, Trumble 2002, and Wong 2003) and 6 moderate quality (Agee 1992, Aslani 2012,  Dumontier 1995, Ferdinand 2002, Jacobsen 1996, and Tian 2007) studies evaluated whether endoscopic carpal tunnel release provided any benefit over open or “mini-open” release at early follow up (3 months to one year). Three high quality studies (Atroshi 2009, Saw 2003 and Trumble 2002) favored endoscopic release for symptom relief in the first 3-6 months after surgery and one study (Saw 2003) demonstrated an earlier return to work. One high quality (Atroshi 2009) and one moderate quality study (Tian 2007) examined long term outcomes for endoscopic release versus open release and did not find any advantage of one method over the other. Studies comparing “mini-open” to standard release were inconclusive.
 

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