Journal of Hand Surgery Global Online (Sep 2025)
Clinical Outcomes Following Endoscopic Carpal Tunnel Release With the Arthrex NanoScopic Release System—A Single Surgeon Experience
Abstract
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. Type of study/level of evidence: Prognostic II.
