Abstract
Endoscopic carpal tunnel release (ECTR) has advanced considerably since its introduction, providing a minimally invasive alternative to traditional open surgery for carpal tunnel syndrome. This review traces the history of ECTR, highlighting key advancements in techniques and variations. We compare the anatomical visualization between endoscopic and open approaches, particularly regarding nerve and tendon preservation. The role of Wide Awake Local Anaesthesia No Tourniquet (WALANT) in ECTR is discussed, with a focus on its benefits in reducing postoperative pain and recovery time. Additionally, we present our approach to bilateral ECTR, illustrated through pictorial representations, demonstrating the advantages of this technique. We conclude that bilateral ECTR not only accelerates overall recovery but also has the potential to reduce overall healthcare costs.