Endoscopic carpal tunnel release (ECTR) is preferred over mini-open release. Despite the overwhelming advantage of endoscopic carpal tunnel release over open technique which involves much greater tissue injury, discomfort, and delay in return to work, there is still a controversy among many surgeons- most of them don't offer state-of-the-art care in the surgery, postoperative, medication and rehab. But even in other countries such as Seoul, Korea, Drs. Kang and associates evaluating 52 patients with bilateral carpal tunnel syndrome confirmed the patients all overwhelmingly prefer the endoscopic technique. Each patient had one side done endoscopically and the other side via a small open incision (Clinical Orthopaedics Related Research, 2013, Vol. 471; pg. 1548-1554).
What the supporters of open filet-of-wrist carpal tunnel release failed to understand is how rapidly and completely a person can return to work after ECTR. The other thing that gets in the way is the old adage that "those who know how to do it are doing it and those who don't... teach!" My patients have been returning to work the next day after surgery for about 18 years. Before that they were returning to work within five to seven days of the surgery. This would rarely be possible after open carpal tunnel release. The monetary savings from being able to immediately return to work for those who are employed cannot be overstated. The added benefit is the absence of an ugly scar.