ABSTRACT
Carpal tunnel syndrome was recognized by Sir James Paget in
1854 as a median nerve compression following a fracture of the
distal radius (1,2). Later in 1880, James Putman, a neurologist
from Boston, reported the symptoms suffered by a group of his
patients (3) which would be considered as a description of a
classic carpal tunnel syndrome today. The first formal descrip-
tion of the surgical release of transverse carpal ligament for the
treatment of this pathologic condition was reported in 1933 (4)
followed by Phalen’s classic article in 1950 (5). Since that time,
open carpal tunnel release has been established as the gold
standard for the surgical treatment of carpal tunnel syndrome.
Dr. James C.Y. Chow began working on endoscopic release of
the transverse carpal ligament in 1985, unaware that both Dr.
Ichiro Okutsu in Japan and Dr. John Agee in California were
working on similar aims at approximately the same time. The
primary motivation of Dr. Chow’s concept was to create a
method for the surgical treatment of carpal tunnel syndrome
that could be able to preserve normal anatomic structures of the
wrist and hand by minimizing the surgical wound and thus,
resulting in a better clinical outcome. Through persistent trials
and different approaches, a slotted cannula was developed late
in 1986. Following several months of repetitive practice on
cadaveric hands, the procedure was completed in May 1987
and it was first performed in a patient in September of the same
year. There have been some modifications of the original
procedure since its conception.
