What is endoscopic carpal tunnel release?

In short

Endoscopic carpal tunnel release is an operation that divides the ligament forming the roof of the carpal tunnel, using a camera passed through a small incision at the wrist crease instead of a cut down the palm. Dividing that band takes the pressure off the median nerve. The skin is closed with skin glue and a dressing.

Written for patients by The Hand and Wrist Institute. Prepared for review by John T. Knight, MD. Last updated September 5, 2026How we write and review

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What endoscopic carpal tunnel release is

Let's take a look at the tunnel itself first, because the operation is named after it. The carpal tunnel is a passage in the front of the wrist. Its floor and sides are the small bones at the back of the wrist, and its roof is a thick, unyielding band, or what we call the transverse carpal ligament. Running through that passage, alongside the tendons that bend your fingers, is the nerve that supplies the thumb, index, middle and half of the ring finger.¹ When the lining of those tendons swells inside a space that cannot stretch, the nerve is what gets squeezed.

Endoscopic release solves that by dividing the roof. Dr. Knight makes a short incision across the wrist crease, passes an endoscope into the tunnel so the underside of the ligament shows on a monitor, and cuts the ligament from the inside out under direct view. The nerve is inspected on the way out and left alone. It is the ceiling of the room being taken off, not anything inside the room being removed.

Endoscopic release, or open release

Well, this is the distinction most people are actually asking about, and it is a matter of how the surgeon gets to the ligament, not of what gets cut. In an open release the surgeon reaches the ligament through an incision in the palm and divides it from above. In an endoscopic release the ligament is reached through a small incision at the wrist crease and divided from underneath, with a camera showing the cut.¹ The same ligament is divided either way.

Here is the test you can apply when you are reading about someone else's surgery. Ask where their scar is. A scar running down the middle of the palm is an open release. A scar sitting in the crease of the wrist is the endoscopic approach. That single detail explains most of the differences in the stories you will hear.

How Dr. Knight closes it

The word you will see on old marketing pages for this operation is not a description, and this page will not use it. Here is what is actually done at the end of the procedure, in order:

1. The tourniquet comes down and direct pressure is held on the incision for about five minutes.
2. The fingers and palm are watched as the color comes back into them.
3. Skin glue is applied liberally over the incision rather than a row of sutures.
4. A small sponge and an adhesive film dressing go on over the glue.
5. That dressing is what lets you shower without waiting for the wound to be uncovered.

When to call us

• The incision is red beyond its edges, warm, draining, or you have a fever.
• Pain is rising after the first several days instead of settling.
• The dressing has lifted, soaked through, or got wet before it was due to come off.
• The numbness that surgery was meant to relieve has come back after improving.
• You have lost the ability to bend or straighten fingers on the operated hand.