Carpal tunnel surgery: in-office options

Friday, December 15, 2017

By: Molly Soto

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More than 500,000 people in the United States undergo surgeries for carpal tunnel syndrome every year. This surgery is among the most common hand surgery.


Dr. Steven C. Schmidt, a plastic surgeon with Plastic Surgery & Skin Specialists by BayCare Clinic, has been doing carpal tunnel surgery for 25 years.


More recently, he was trained on another surgical approach, Thread Carpal Tunnel Release, by Dr. Danzhu Guo of BayCare Clinic Pain & Rehab Medicine, who co-developed this approach with his brother, Dr. Danqing Guo.


“TCTR is a method of doing a carpal tunnel release without using a knife or making an incision in the palm,” says Schmidt, who is board certified by the American Board of Plastic Surgery.  “We cut the exact same structure that we cut in a regular carpal tunnel release, we’re just getting to it in a different way.”


Details of in-office surgery

Both the more common carpal tunnel release surgery and TCTR can be performed in the office for most patients. One of the major benefits is that in-office surgery costs less than surgery done in a hospital or surgery center’s operating room.


To determine whether a patient qualifies for in-office surgery, Dr. Schmidt looks at their anxiety level, their need for sedation and whether they’ve had prior carpal tunnel release surgery or recurrent carpal tunnel syndrome.


“Other than those who have had prior surgery or recurrent disease, there are not many reasons you can’t do in-office surgery on people,” Schmidt says. “The patient is very comfortable throughout the procedure.”


Comparing the two types of in-office surgery

Both types of in-office surgeries provide similar long term outcomes, however the short term recovery may differ between the procedures.


“Patients typically have discomfort in their palm when they push up on objects, lift weight or power grasp for 3 to 4 months following surgery because of the structure we divide to do the carpal tunnel release, so, there’s no way to avoid that,” Schmidt says. “What we have observed is that most patients have less pain following the TCTR procedure than the open surgery, but that it still being studied.”


“I think TCTR offers patients an improvement in terms of less discomfort in their palm immediately following surgery,” Schmidt says. “But the long-term outcomes should be no different than any other carpal tunnel release.”


What to choose?

“Both ways are safe and effective ways to have a carpal tunnel release done. The biggest thing is that the patient feels comfortable with their surgeon and the technique that their surgeon is using,” Schmidt says.


Our plastic surgeons, Dr. Schmidt, Dr. Elizabeth A. O’Connor and Dr. James Zasuly, treat a wide spectrum of hand- and wrist-related conditions caused by traumatic injuries, degenerative conditions or workplace exposure. 


Whether it’s a hand issue that you’ve struggled with for a long time, something that happened suddenly, or you’re seeking a second option – call us at 920-288-8240 or request an appointment online.

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Steven C. Schmidt, MD, is a Board Certified plastic surgeon. Dr. Schmidt earned his medical education at Washington University in St. Louis and completed a residency at the Hospital of the University of Pennsylvania in General and Plastic Surgery where he also completed a fellowship in Hand Surgery. Dr. Schmidt offers complete plastic, cosmetic, and hand surgery services in Northeast Wisconsin.


Elizabeth A. O’Connor, MD, received her medical degree from Wayne State University School of Medicine in Detroit. She completed her residency in plastic surgery at the Medical College of Wisconsin in Milwaukee. Dr. O’Connor is fellowship trained in Aesthetic and Reconstructive Breast Surgery. Learn more about her here.


James Zasuly, MD, is a Board Certified plastic surgeon. Dr. Zasuly earned his medical education at Texas A&M in College Station, Texas.

He has completed seven years of residency training which includes learning the latest techniques in cosmetic surgery of the breast, body, and face as well as breast reconstruction.  Dr. Zasuly offers complete skin cancer, reconstructive, and plastic surgery services of the face, body and hands in Northeast Wisconsin.

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BayCare Clinic,, is the largest physician-owned specialty-care clinic in northeastern Wisconsin and Michigan’s Upper Peninsula. It is based in Green Bay, Wisconsin. BayCare Clinic offers expertise in more than 20 specialties, with more than 100 physicians serving in 16 area communities. BayCare Clinic is a joint partner in Aurora BayCare Medical Center, a 167-bed, full-service hospital. Follow BayCare Clinic on Facebook and Twitter.