[MUSIC PLAYING] So carpal tunnel release has been performed for decades, first with an open technique which is with an incision on the palm.

In the late 90s, it was developed in endoscopic technique which is a technique using a camera in a device that goes into the wrist from the wrist crease to avoid making that incision on the palm.

That's been done in the OR for years.

I started doing that in training, and then when I started practice in 2012 I've been doing endoscopic carpal tunnel releases in the OR, approximately over 2,000 at this point, using a single port technique.

The major roadblocks for moving it out of the OR were the equipment.

So whenever you do anything with a scope, you usually need a lot of equipment-- a tower, a light, a monitor.

With newer technologies, we have disposable cameras that connect to tablets which we can connect to a television, which allows us to take that procedure purely mechanically out of the OR.

The advantage of taking it out of the OR also decreases the anesthesia time in regards to I can do a local block at the wrist, keep the patient awake so that they don't have to have the medications and the risks of anesthesia.

It also cuts down on time and increases efficiency quite a bit.

Patients are usually at the facility for just about under an hour, on average of about 50 minutes.

They arrive, I do a wrist block in the preoperative area, go back and do another case, and let them sit for about 10, 15 minutes till the local anesthetic's set up.

We go back to the operating room, and the procedure takes about 5 to 10 minutes and then about a 10-minute recovery in the recovery area and patients are out usually in about 15 minutes.

I think a lot of people with carpal tunnel, whether it be a very mild case or a very severe case, don't really look for relief because they're afraid of the consequences or the downtime.

So the concept of a surgery to patients is sometimes a major issue in regards to the interruption in their daily lives.

By taking out of the OR, number one, the day of the procedure it really cuts down on the amount of time dedicated to that procedure during that day.

Rather than dedicating the entire day to that, they literally come in after having breakfast, drive themselves, have the procedure, go home or go out to lunch.

With the endoscopic carpal tunnel release technique, the incision is much smaller and it's on the wrist crease as opposed to in the palm.

So while you're still doing the same thing on the interior of the wrist, you aren't cutting through the muscles in the fat of the palm, so there's much less recovery in regards to healing the incision.

So patients usually go back to work at a much quicker rate than with a traditional technique.

The best compliment you can get from a patient is a patient with a patient referral.

And I've seen a lot of patients who have talked to my other patients who had it done this way.

The other way they compliment me is by having the other side done.

So a lot of them have bilateral carpal tunnel, and usually within a couple of weeks they're asking to do the other side because they're sleeping that much better because that hand isn't bothering them.

And the one that they haven't had done is still keeping them up at night.

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