Minimally Invasive Device Relieves Carpal Tunnel Syndrome

An innovation in carpal tunnel surgery gives surgeons the option to release the transverse carpal ligament (TCL) through a miniscule surgical access and in less than ten minutes.

The MANOS Carpal Tunnel Release system is designed to minimize surgical trauma and reduce patient recovery times. The procedure is performed through two small skin incisions that are placed distal and proximal to the TCL, under a local anesthetic. The Manos cannula is then inserted under the ligament, and hooked up to a standard nerve stimulator. The characteristic movement of thenar muscles from a stimulation of a motor branch of median nerve tells the surgeon where the nerve bundle is located. Following that, the ligament can be released, when the previously blunt cannula is converted into a cutting device. Once the TCL is cut, pressure is relieved in the carpal tunnel. This decompresses the pinched median nerve, eliminating the symptoms associated with carpal tunnel syndrome (CLS).


The system is placed via openings measuring as little as 2.1 mm; thus, after the procedure, only two small band-aids are needed to cover the surgical access points, since stitches are not normally required and scarring is minimized or eliminated. Patients typically recover quickly, with some patients returning to work as early as the same week of surgery. Postoperative care is limited and generally does not include splinting or physical therapy. The MANOS Carpal Tunnel Release system is a product of Thayer Intellectual Property (San Francisco, CA, USA), and has been approved by the US Food and Drug Administration (FDA).

CTS refers to idiopathic median neuropathy at the carpal tunnel, the pathophysiology of which is not completely understood; risk factors are primarily genetic rather than environmental. The main symptom of CTS is intermittent numbness of the thumb, index, long and radial half of the ring finger. The numbness usually occurs at night and is relieved by wearing a wrist splint that prevents flexion. Long-standing CTS leads to permanent nerve damage with constant numbness, atrophy of some of the muscles of the thenar eminence, and weakness of palmar abduction.

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