In 1990 the trend was to perform endoscopic surgery (keyhole surgery), however, this technique often leads to injuries of the main nerve (median nerve) or the thumb-motor branch. Due to a range of anatomical variations in the course of the median nerve and its branches, sometimes the main trunk divides earlier, or the motor branch-thumb does not leave the main trunk on the thumb side but on the little finger. These anatomical variations associated with the endoscopic technique, also in experienced surgeons, are often too late or not at all recognized which can result in almost irreparable injury.
I place two small incisions during the operation, so we can see all structures clearly and “accidents” can be avoided. The healing period in comparison to the endoscopic technique is only a bit extended. Both possibilities emerged from a prospective study at the Vienna-AKH.
The health insurance companies of course cover the cost of the operation.