Nuances in endoscopic carpal tunnel release a guide to improving outcomes.

Endoscopic technique of carpal tunnel release is widely accepted as successful and safe as long as the surgeon is well-trained. Compared to the traditional open technique, there exists a steep learning curve for familiarisation of equipment, training of hand-eye coordination and appreciating tactile feedback. The available literature and manuals do not illustrate the practical challenges encountered during the procedure. We describe a guide for single-portal technique under local anesthesia, including surgical planning, cautions, and troubleshooting processes based on our experience with 136 cases in Asian hands which is known to be smaller.