Carpal Tunnel Treatment with the Brown Procedure

The Brown Procedure is our carpal tunnel treatment of choice, safely and easily performed on an outpatient basis. A small 9mm incision (less than 1/2”) is made very near the wrist and a tiny 4mm (less than 1/4”) incision is made in the palm. The instrumentation is inserted, isolating the transverse carpal ligament from the contents of the carpal tunnel. The ligament is then divided with endoscopic visualization as the surgeon watches the video monitor. While the surgeon’s assistant holds the patient’s hand, hyper extended, and moves the endoscope, the ligament is divided with endoscopic visualization by the surgeon who watches on a video monitor.

A long-acting anesthetic is placed in the tiny incisions, typically eliminating post-operative discomfort, numbing the hand for 4-48 hours, after which time pain medication is rarely needed. The wounds are closed with Steri-Strip* adhesive skin closures, rather than stitches.

During the next seven days, the patient is able to use the hand. After seven days, the dressing and Steri-Strip* closures are removed and patient may use his or her hand without restriction.

This procedure, created by Dr. Michael Brown, has demonstrated long-term patient safety and effectiveness. Compare the Brown Procedure to open carpal tunnel release – you will see immediate differences and our procedure’s benefits.

Example of the Brown Procedure for endoscopic carpal tunnel treatment:

Endoscopic view of the transverse carpal ligament

This is a clear, endoscopic view of the transverse carpal ligament, isolated, about to be released without injury to the overlying structures. Typically, there are no restrictions after seven days.

Hand after carpal tunnel treatment

After healing, the two tiny incisions are hardly visible. There are no stitches.

Example of common open carpal tunnel release:

Open carpal tunnel release

This is the extent of surgical dissection of the hand required in an open carpal tunnel release. Healing and recovery may require months.

Scar after open carpal tunnel release surgery

The extensive post-operative wound persists as a scar in the palm, often permanently tender.

The Brown Procedure should not be confused with other endoscopic techniques that do not have the same safety and effectiveness, as has been shown in “A 12-Year Experience Using the Brown Two-Portal Endoscopic Procedure of Transverse Carpal Tunnel Ligament Release in 14,722 Patients: Defining a New Paradigm in the Treatment of Carpal Tunnel Release.” Other endoscopic techniques used in carpal tunnel treatment have been associated with significant complications.

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