to another duty in order to minimize further stress on their hands. in general, endoscopic techniques are as effective as traditional open carpal surgeries, though the faster recovery time (2–3 weeks) typically noted in endoscopic procedures is felt by some to possibly be offset by higher complication rates. a recent cochrane review showed that the use of absorbable sutures (stitches that the body dissolves) provide the same outcomes (i.e. scar quality, pain levels, etc) as non-absorbable sutures but are much cheaper. risks and complications complications and failures are estimated to be 3% to 19%. unrelieved symptoms may lead to repeat operation in 12% of patients. because most patients obtain relief in the early postoperative period, it is difficult to attribute one anatomical cause to recurrent symptoms. findings reported at reoperation include incomplete release of the transverse carpal ligament, re-formation of the flexor retinaculum, scarring in the carpal tunnel, median or palmar cutaneous neuroma, palmar cutaneous nerve entrapment, recurrent granulomatous or inflammatory tenosynovitis, and hypertrophic scar in the skin. as with most soft-tissue surgeries of the hand, postoperative wound infection is rare after ctr, occurring in only 0.36% of cases. most of these are superficial, with only 0.13% of cases having deep infections. the most common complication with open carpal tunnel release surgery is pillar pain (pain in the thenar or hypothenar eminence that is worse with pressure or grasping), followed by laceration of the palmar cutaneous branch of the median nerve. pillar pain occurs in approximately 25% of surgical cases, with symptom resolution reported in most patients by 3 months. there is no difference in the rates of pillar pain between patients undergoing open or endoscopic release. incomplete release of the tcl with persistent or recurrent cts symptoms is the most frequent complication attributed to endoscopic carpal tunnel release surgery. recurrent cts develops in 7% to 20% of surgical cases. the problem is difficult to address, and revision surgery is less successful than primary carpal tunnel release surgery. injury to the median nerve proper occurs in 0.06% of cases. risk of nerve injury has been found to be higher in patients undergoing endoscopic ctr compared with open, though most are temporary neurapraxias. the palmar cutaneous branch of the median nerve may be injured during superficial skin dissection or while releasing the proximal portion of the transverse carpal ligament with scissors or an endoscopic device. nerve injury can lead to persistent paresthesias or painful neuroma formation. in addition to pain, patients may have mechanical symptoms related to the flexor tendons contained in the carpal tunnel after release of the transverse carpal ligament. damage to the tendons during release may cause inflammation and adhesions leading to triggering at the wrist. balloon carpal tunnelplasty balloon carpal tunnelplasty is an experimental technique that uses a minimally invasive balloon catheter director to access the carpal tunnel. as with a traditional tissue elevator-expander, balloon carpal tunnelplasty elevates the carpal ligament, increasing the space in the carpal tunnel. as an experiment it has been described but there are no peer-reviewed series available in the current hand surgical literature that review or comment upon the procedure. the technique is performed through a one-centimeter incision at the distal wrist crease. it is monitored and expansion is confirmed by direct or endoscopic visualization. the technique's secondary goals are to avoid to incision in the palm of the hand, to avoid cutting of the transverse carpal ligament, and to maintain the biomechanics of the hand.