The endoscopic carpal tunnel release (ECTR) procedure requires a special endoscope that can only be used in an operating room (OR). The open technique can also be carried out in an OR in a practice, but we still carry out all our operations in a real OR. In a fully equipped OR, the sterile conditions ensure that the procedure is hygienic and safe, in comparison to a smaller OR in a practice. The cost to the patient remains the same.