<P> Open surgery involves an incision on the palm about an inch or two in length . Through this incision, the skin and subcutaneous tissue is divided, followed by the palmar fascia, and ultimately the transverse carpal ligament . </P> <P> The open release technique has been compared to other treatments . </P> <P> Endoscopic techniques for carpal tunnel release involve one or two smaller incisions (less than half inch each) through which instrumentation is introduced including a synovial elevator, probes, knives, and an endoscope used to visualize the underside of the transverse carpal ligament . The endoscopic methods do not divide the subcutaneous tissues or the palmar fascia to the same degree as the open method does . Many studies have been done to determine whether perceived benefits of a limited endoscopic or arthroscopic release are significant . </P> <P> Many surgeons have embraced limited incision methods . It is considered to be the procedure of choice for many of these surgeons with respect to idiopathic carpal tunnel syndrome . Supporting this are the results of some of the previously mentioned series that cite no difference in the rate of complications for either method of surgery . Thus, there has been broad support for either surgical procedure using a variety of devices or incisions . </P>

When was the first carpal tunnel surgery done