Six procedures, done in our office.
Each of these is done in our procedure room with local numbing only. Compare what’s involved, how long recovery usually takes, and what it costs if you pay directly.
Endoscopic Carpal Tunnel Release
Carpal tunnel syndrome happens when the median nerve is squeezed at the wrist. It causes numbness and tingling in the thumb, index and middle fingers, often waking you at night. Over time it can weaken the thumb muscles.
Using a small camera through one tiny incision at the wrist crease, Dr. Jackson releases the transverse carpal ligament, the tight band that forms the roof of the tunnel, from underneath. That opens space for the nerve. The palm skin isn’t cut.
Many patients have less palm tenderness in the first few weeks and return to work a little sooner than with open release. Long-term results are similar. It isn’t right for everyone: some anatomy, repeat surgeries, and certain wrist conditions do better with open release.
- Incision
- Less than ½ inch, at the wrist crease
- Procedure time
- About 10–15 minutes
- Aftercare
- Bandage for 24 hours; normal light use right away. The stitch is absorbable, so there’s nothing to remove.
Typical recovery
Awake advantage: endoscopic release is often done in an operating room with sedation. Doing it wide-awake in our procedure room avoids the facility and anesthesia fees. It costs more than open release because of the cost of the camera and scope equipment.
Open Carpal Tunnel Release
Open release treats the same problem as endoscopic release: pressure on the median nerve at the wrist.
Through a short incision in the palm, Dr. Jackson divides the transverse carpal ligament directly. The open approach gives a direct view of the ligament and nerve and works well for almost every patient, including repeat surgery.
- Incision
- About 1 inch, in the palm
- Procedure time
- About 10–15 minutes
- Aftercare
- Bandage for about 3 days; move your fingers right away
Typical recovery
Awake advantage: no tourniquet on your arm, so there’s no cuff pain. Night-time tingling often improves within days. Numbness that has been there a long time may recover slowly.
Trigger Finger Release (A1 Pulley)
With trigger finger, the tendon that bends your finger catches on the first “pulley” (the A1 pulley) at the base of the finger. The finger clicks, locks, or gets stuck bent, especially in the morning. A tender bump in the palm is common.
Dr. Jackson releases the A1 pulley through a small incision in the palm, letting the tendon glide freely. More than one finger can be treated in the same visit.
- Incision
- About ½ inch, at the base of the finger
- Procedure time
- About 5–10 minutes per finger
- Aftercare
- Bandage for about 3 days; bend and straighten often
Typical recovery
Awake advantage: you make a full fist and straighten the finger on the table, so Dr. Jackson can confirm the catching is gone before closing.
De Quervain’s Release
De Quervain’s causes pain on the thumb side of the wrist when you grip, lift or twist. It’s common in new parents and people who do repetitive lifting. The two tendons that move the thumb are squeezed inside a tight tunnel called the first dorsal compartment.
When splints and injections haven’t helped, Dr. Jackson opens the roof of that compartment through a small incision, carefully protecting the small sensory nerve nearby.
- Incision
- About ¾ inch, thumb side of the wrist
- Procedure time
- About 10–15 minutes
- Aftercare
- Bandage for about 3 days; gentle thumb motion right away
Typical recovery
Awake advantage: you move your thumb during surgery, which helps confirm both tendons glide freely. Sometimes there’s a hidden extra tunnel, and your movement helps find it.
Mucous Cyst Excision
A mucous cyst is a small fluid-filled bump on the back of the finger near the nail. It usually comes from wear-and-tear arthritis in the last knuckle. It may drain a jelly-type fluid, or press on the nail bed and cause a groove in the nail.
Dr. Jackson removes the cyst and the small bone spur underneath it. Removing the spur is what lowers the chance the cyst comes back.
- Incision
- Small curved incision over the last knuckle
- Procedure time
- About 15–25 minutes
- Aftercare
- Bandage for about 3 days; move the finger right away
Typical recovery
Good to know: a nail groove caused by the cyst grows out with the nail, which takes several months.
Finger Mass Excision
Most finger lumps are benign. Common ones include tendon-sheath ganglion cysts (a firm “pea” at the base of the finger), giant cell tumors of the tendon sheath, and epidermal inclusion cysts. Lumps that grow, hurt, or get in the way are usually worth removing.
Dr. Jackson removes the mass through an incision planned around the nerves and tendons nearby. Solid masses are sent to a lab for testing so you know exactly what it was.
- Incision
- Depends on size and location
- Procedure time
- About 15–30 minutes
- Aftercare
- Bandage for about 3 days; finger motion right away
Typical recovery
Good to know: the pathology lab bills separately for testing the tissue.
Recovery ranges are typical for healthy adults returning to everyday activities. Your timeline depends on your job, your hand, and how things heal. Heavy manual work may take longer. We’ll give you a plan for your situation.
Find out if wide-awake surgery is right for you.
Call (210) 729-1900 or book online. You’ll always reach a real person.