In endoscopic carpal tunnel release surgery, the transverse carpal ligament is cut, releasing the median nerve.

Endoscopic surgery uses a thin tube with a camera attached (endoscope). The endoscope is guided through a small incision in the wrist (single-portal technique) or at the wrist and palm (two-portal technique). The endoscope lets the doctor see structures in the wrist (such as the transverse carpal ligament) without opening the entire area with a large incision.

The cutting tools used in endoscopic surgery are very tiny and are also inserted through the small incisions in the wrist or wrist and palm. In the single-portal technique, one small tube contains both the camera and a cutting tool.

During endoscopic carpal tunnel release surgery, the transverse carpal ligament is cut. This releases pressure on the median nerve, relieving carpal tunnel syndrome symptoms.