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Tiny video camera aids hand surgery.

Workers who depend on their hands for their livelihood--such as typists, factory employees, and repair technicians--sometimes may find themselves facing a debilitating pain that prevents them from completing even simple tasks. Although plastic surgery can repair carpal tunnel syndrome, which costs American industry billions of dollars each year in lost work time, previous surgical techniques have resulted in patients' recovery taking six weeks or longer--until now.

By using endoscopic surgery, a procedure that involves burrowing a tiny camera under the skin to view the area that needs treatment, doctors can perform surgery literally by watching TV "We've revolutionalized what used to be invasive surgery with minimally invasive surgery," explains John Moore of the Plastic Reconstructive Hand Surgery Center, Olathe, Kans., who uses endoscopic surgery to relieve carpal tunnel syndrome. "We're trying to reduce the amount of damage you do with normal tissue by using a tiny videocamera that's inserted into the hand through a half-inch incision at the wrist. Through that camera, we then enlarge the carpal tunnel to take the pressure off the nerves and the wrist." As a result, patients can return to work about twice as quickly as when other procedures are used, suffer less pain, and usually are surprised to discover they can use their hands almost immediately, although the total recovery time is about three weeks.

During endoscopic carpal tunnel release, the surgeon pierces the hand to form an opening for the camera, which acts as the doctor's eyes. Pressure on the hand's nerves then is relieved by "opening up" the area of pressure. "Tendonitis leads to swelling of the tendons, which leads to pressure on the nerve, which leads to carpal tunnel. It's just like when you cross your legs and they go to sleep--this is your hands going to sleep, but it's based on internal pressure rather than external."

In previous operations, the incision could run four to eight inches long, from the palm up through the forearm, and involve wrappings and total rest of the hands. Another advantage to the endoscopic technique is that it allows surgery under local anesthesia rather than general.
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Publication:USA Today (Magazine)
Date:Feb 1, 1993
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