内窥镜下腕管释放与关节纳米释放系统的临床效果-一个外科医生的经验

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-08-13 DOI:10.1016/j.jhsg.2025.100780

Sina Ramtin MD , Asif M. Ilyas MD, MBA

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引用次数: 0

摘要

目的内镜下腕管松解术（ECTR）是开放性松解术的一种微创替代方法，恢复更快，减少术后不适。Arthrex NanoScopic ECTR系统是一种新型的一次性设备，使用尖端芯片数字成像，设计用于局部麻醉下，无需关节镜设备，可以进一步简化护理并扩大手术范围。方法回顾性分析一名接受过单手培训的手外科医生使用关节纳米镜系统进行的前50例ECTR手术。所有手术均在门诊外科中心全清醒局麻下完成，无止血带技术。结果包括手术时间、不良事件、感染、再次手术需求和麻醉转换率。术后随访患者至少3个月。结果37例患者（13例双侧）共行50例手术，中位年龄58岁。所有病例均在局麻下完成，未转镇静或全麻。平均手术时间8分钟，总住院时间平均22分钟。无再操作发生。4例（8%）患者发生术后正中神经炎，其中3例自行消退，1例归因于潜在的多神经病变。1例患者因与手术部位无关的疼痛就诊于急诊科，1例患者出现浅表伤口感染，经口服抗生素治疗。结论Arthrex纳米ECTR系统是一种安全、有效、微创的腕管综合征全清醒局麻无止血带减压方法。其一次性使用、便携的设计可以减轻手术负担，并扩大在办公室或门诊环境下进行内窥镜释放的机会。早期结果显示并发症发生率低，手术成功率高，支持在更广泛的临床实践中进一步评估该技术，特别是在办公室环境中。研究类型/证据水平预后II。

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Clinical Outcomes Following Endoscopic Carpal Tunnel Release With the Arthrex NanoScopic Release System—A Single Surgeon Experience

Purpose

Endoscopic carpal tunnel release (ECTR) is a minimally invasive alternative to open release, offering faster recovery and reduced postoperative discomfort. The Arthrex NanoScopic ECTR system, a novel single-use device using chip-on-tip digital imaging and designed for use under local anesthesia without arthroscopic equipment, may further streamline care and expand surgical access.

Methods

A retrospective review was conducted of the first 50 consecutive ECTR procedures performed using the Arthrex NanoScopic system by a single hand fellowship-trained hand surgeon. All procedures were completed under wide-awake local anesthesia no tourniquet technique in an outpatient surgical center. Outcomes included operative times, adverse events, infections, need for reoperation, and anesthesia conversion rates. Patients were followed for a minimum of 3 months after surgery.

Results

A total of 50 procedures were performed on 37 patients (13 bilateral), with a median age of 58 years. All cases were completed under local anesthesia without conversion to sedation or general anesthesia. The average operative time was 8 minutes, with the total room time averaging 22 minutes. No reoperations occurred. Four patients (8%) developed postoperative median neuritis, with three cases resolving spontaneously and one attributed to underlying polyneuropathy. One patient presented to the emergency department for pain unrelated to the surgical site, and one patient developed a superficial wound infection resolved with oral antibiotics.

Conclusions

The Arthrex NanoScopic ECTR system appears to be a safe, efficient, and minimally invasive option for carpal tunnel syndrome decompression under wide-awake local anesthesia no tourniquet. Its single-use, portable design may reduce the procedural burden and expand access to endoscopic release in office-based or ambulatory settings. Early outcomes demonstrate low complication rates and high procedural success, supporting further evaluation of this technique in broader clinical practice, particularly in an office setting.