Select Page

Carpal Tunnel Surgery

In the event that medical or conservative treatment fails, carpal tunnel surgery is conclusively indicated.

The purpose of surgery is to reduce the pressure in the canal to allow the nerve fibres to reoxygenate. The procedure consists of incising the transverse ligament that forms the roof of the canal so that it opens and the volume in the canal increases. The pressure therefore immediately decreases, and the nerve is decompressed.

The conventional or “open” decompression method

Conventional surgery (the method currently available in hospitals) is performed with a two to three-centimetre-long incision in the palm of the hand. The opening allows the transverse ligament of the carpus to be cut to enlarge the canal, but this technique requires the following structures to be sacrificed and cut;

  • the skin
  • subcutaneous fatty tissue, which often contains small nerve fibres
  • the muscle just above the transverse ligament of the carpus

This classic technique provides good results but has many disadvantages:

  • it unnecessarily sacrifices important structures
  • the healing period is considerably longer
  • the risks of adhesion and post-operative stiffness increases
  • the scar in the palm of the hand may remain hypersensitive for months and may be unsightly
  • the loss of postoperative strength can last for about four to six months
  • The treatment of both hands should usually be separated by two to three weeks

The endoscopic method

Endoscopic decompression using the Smart Release® system is the most efficient and rapid method of treating carpal tunnel syndrome. This ultra-modern and minimally invasive technique is performed in a few minutes under local anaesthesia and without stitches.

Procedure for the intervention

A 1 cm mini-incision is made on the wrist to insert miniaturized devices to cut the ligament responsible for nerve compression. Unlike the traditional method, the skin and muscles of the hand are not affected. The pain is minimal and the relief of symptoms is immediate. 

The operation lasts about ten minutes and is performed while the patient is completely awake. This method does not require postoperative care and the patient can quickly return to his or her activities. Both hands can be treated in a single session, significantly shortening the recovery period. 

Although the effectiveness rate of both methods is comparable and both have very low complication and recurrence rates, endoscopic release offers significant comfort and productivity benefits. 

Because of its less invasive nature, it provides rapid symptomatic relief, improved motor recovery and a much faster return to normal activities.*

  • Minimally invasive technique
  • Low discomfort and low risk of complications
  • Immediate relief of numbness
  • Direct improvement of sleep quality
  • Minimal downtime – Most patients regain hand use within 24 to 48 hours
  • Allows both hands to be treated in one session 

Dr. Brutus is a pioneer in endoscopic hand surgery in Canada and has already successfully operated on several thousand patients.

Contact us now
It will be our pleasure to give you an appointment for a consultation and treatment in the next few days.




Rated 5 stars on more than 130 reviews

Relieve your pain quickly

Relieve your pain quickly

Download our free guide on the carpal tunnel syndrome

Self help book for carpal tunnel syndrome: The essential guide to a quick recovery

Dr. Jean-Paul Brutus and Nathalie Brisebois (Occupational Therapist) answer the most frequently asked questions about carpal tunnel syndrome and offer advice to treat the disease without surgery.

Self help book for carpal tunnel syndrome:The essential guide to a quick recovery

Dr. Jean-Paul Brutus and Nathalie Brisebois (Occupational Therapist) answer the most frequently asked questions about carpal tunnel syndrome and offer advice to treat the disease without surgery.

Lacertus syndrome and double compression of the median nerve

A significant proportion of people with carpal tunnel syndrome also have Lacertus syndrome.

Lacertus syndrome is caused by compression of the median nerve at the elbow. Its symptoms are similar to those of CTS and typically manifest as numbness, loss of strength, decreased manual dexterity and pain in the forearm. The two conditions are frequently associated (called double compression), but they can exist on their own.

Because the symptoms of Lacertus syndrome are often confused with those of CTS, its diagnosis is often missed or made late. Unfortunately, many doctors fail to look for a secondary cause or have inadequate training in detecting the disease. These diagnostic errors are a very common cause of carpal tunnel surgery failure.  

Diagnostic

All patients with hand numbness in the area corresponding to the median nerve (middle, index, thumb) should be examined not only for carpal tunnel syndrome, but also for compression of this nerve in the elbow, under the lacertus fibrosus. The scratch collapse test is a very little known physical examination manoeuvre, but very useful for the diagnosis of nerve compression, such as CTS or Lacertus syndrome.

Surgical treatment

Until recently, surgical treatment of Lacertus syndrome required general or regional anaesthesia with a very long incision in the forearm. The results were random due to the aggressiveness of the surgical approach and its complications.  Its treatment is now much less invasive, thanks to advances in surgical and anaesthesia techniques. The procedure is performed under local anaesthesia (WALANT, or Wide Awake Local Anesthesia No Tourniquet) on a fully awake patient, which confirms the immediate return of strength and verifies the decompression result.

The surgery requires an incision of two or three centimetres in the fold of the elbow. Return to office work is possible 24 to 48 hours later, while physical work is possible after ten to fourteen days.

1- Learn more about carpal tunnel syndrome

2- Learn more about carpal tunnel exercices and treatments

*This information is provided for information purposes only. Results may vary from patient to patient. 

Contact us now
It will be our pleasure to give you an appointment for a consultation and treatment in the next few days.




Rated 5 stars on more than 130 reviews

Soignez vous-même votre syndrome du canal carpien: Votre guide pratique d’autoguérison

Donnez-nous votre courriel afin de recevoir votre guide gratuitement


You have Successfully Subscribed!

Soignez vous-même votre arthrose de la main et de la rhizarthrose: Votre guide pratique pour comprendre et soulager vos symptômes et prévenir les déformations

Donnez-nous votre courriel afin de recevoir votre guide gratuitement


You have Successfully Subscribed!

Guide pratique en matière d'accident de travail au Québec: Comprenez et protégez vos droits

Donnez-nous votre courriel afin de recevoir votre guide gratuitement


You have Successfully Subscribed!

Soignez vous-même votre doigt à ressaut ou doigt à gachette: Votre guide pratique pour soulager votre main

Donnez-nous votre courriel afin de recevoir votre guide gratuitement


You have Successfully Subscribed!

Self help book for carpal tunnel syndrome: The essential guide to a quick recovery

Leave us your email adress to receive your guide


You have Successfully Subscribed!

Treat yourself to osteoarthritis of the hand and rhizarthrosis: Your practical guide to understanding and relieving your symptoms and preventing deformities

Leave us your email adress to receive your guide


You have Successfully Subscribed!

Self help book for trigger finger: The essential guide to a quick recovery

Leave us your email adress to receive your guide


You have Successfully Subscribed!

Libro de autoayuda para síndrome del túnel carpiano: Una guia para una recuperacion rapida. (En español)

Leave us your email adress to receive your guide


You have Successfully Subscribed!

Votre guide pratique pour la maladie de Dupuytren

Donnez-nous votre courriel afin de recevoir votre guide gratuitement


You have Successfully Subscribed!

Votre guide pratique sur le traitement de la ténosynovite de De Quervain

Donnez-nous votre courriel afin de recevoir votre guide gratuitement


You have Successfully Subscribed!

Self-Help Book for De Quervain's Tenosynovitis - The Essential Guide to Quick Recovery

Leave us your email adress to receive your guide


You have Successfully Subscribed!

Self-Help Book for Dupuytren's Disease - The Essential Guide to Quick Recovery

Leave us your email adress to receive your guide


You have Successfully Subscribed!