Minimally Invasive Carpal Tunnel Surgery at UToledo Health Helps Patients Recover Faster

Minimally Invasive Carpal Tunnel Surgery at UToledo Health Helps Patients Recover Faster

Music is often piped into operating rooms, but patients rarely hear it.

However, as UToledo Health orthopaedic surgeon Dr. Martin Skie operated on CarrieAnne Campbell's wrists in late November, the two chatted about Earth, Wind & Fire and the enduring legacy of 1970s disco as they listened to Campbell's curated playlist.

Campbell, an executive assistant at The University of Toledo, was undergoing a newly available treatment for carpal tunnel syndrome that requires no general anesthesia, involves minimal cutting and offers a recovery time measured in weeks rather than months.

It also allowed her to have a front row seat to her own surgery, complete with Skie's narration about each step of the process.

"It was cool to watch, but I like that kind of stuff," she said with a laugh. "I'm excited to get back to doing the things that I love - playing with the dogs, my crafts, cleaning without having to take breaks, driving. All those little things that were hard to do before."

Three weeks after her surgery, Campbell's wrists are still a little tender and she's still regaining her dexterity, but the carpal tunnel symptoms she'd dealt with for the last half-decade have almost completely resolved.

"The numbness and tingling are almost completely gone," she said. "It's nothing compared to my hands falling asleep and how they felt before I had this done. I've noticed a total change. It's a big relief."

Carpal tunnel syndrome occurs when the median nerve, which is responsible for sensation and movement in the hand and fingers, becomes compressed as it passes under the transverse carpal ligament in the wrist. That pressure leads to tingling, numbness and pain in the hands and fingers, particularly when holding things, such as a steering wheel or, in Campbell's case, a crochet hook.

Symptoms also can flare at night, leading to poor sleep. In more advanced cases, prolonged compression can lead to muscle atrophy and even permanent nerve damage.

As many as 10 million Americans suffer from carpal tunnel. Some patients can manage their condition with home care or physical therapy, but severe cases like Campbell's often require surgery.

Traditionally, that's been done in a conventional operating room. A surgeon makes an inch-long incision in the patient's palm and wrist, then carefully divides the transverse carpal ligament to relieve the pressure on the median nerve. The patient would be stitched back up and sent home with a bulky dressing over their incision.

By contrast, the new outpatient procedure offered by UToledo Health is performed under local anesthesia in a standard clinic room and requires only a single micro-incision. Using real-time ultrasound guidance and a specialized tool developed by Sonex Health, the surgeon can precisely locate and divide the transverse carpal ligament while guards on the tool protect nearby nerves and blood vessels.

The entire procedure can take as little as 15 minutes and rarely requires stitches.

"Carpal tunnel is one of the most common conditions we see as hand surgeons," Skie said. "This less invasive option is every bit as good as an open surgery, but it's a lot easier on the patient. There's less prep, there's less pain and they can get back to their daily lives much faster."

Recovery time after an open procedure varies by patient, but even those doing non-physical office work generally have to take off at least a week or two. It can take up to three months to fully recover.

The ultrasound-guided procedure significantly shortens that timeline.

Skie said patients with office jobs are generally back within a few days and most have fully recovered within six weeks. An additional benefit is that patients can have both wrists done at the same time - something generally not recommended with traditional open surgery.

That was appealing to Campbell, who had been living with carpal tunnel in both hands for about five years. She managed the symptoms the best she could, but the pain and numbness were becoming more frequent, and she knew she was likely headed toward surgery.

"There really were no other options at that point," she said. "I'd done the splints. I'd done the exercises. It was just at a point that it was getting in my way of living."

She was familiar with the procedure as her husband had a traditional, open release procedure in 2018. Though it was ultimately effective, his recovery was slow. When she learned UToledo Health offered a less invasive surgery with a much faster recovery time, she quickly signed up for an evaluation.

Campbell had the procedure a little more than a month later.

"This was a way better option," Campbell said. "Instead of getting a long incision from your palm to your forearm and having your hand wrapped and in a splint for six weeks, I was wrapped for 48 hours and back at work four days later."

Though she still has some healing ahead of her, Skie said she's doing well.

"Our goal is always to provide the safest, most advanced treatment options available," he said. "Carpal tunnel release is a very effective procedure in general. This technique makes it even more accessible. We're able to perform the procedure in a simple office setting while maintaining the same strong clinical outcomes as traditional surgery."

Carpal tunnel patients interested in being evaluated to see if they are a candidate for the ultrasound-guided release procedure can call the UToledo Health Orthopaedic Center at 419.383.3761 to schedule an appointment.