A system and method for nerve decompression comprise a knife unit having a parallel upper limb and lower limb terminating proximally at the cap of the tubular sheath and a triangular shaped surgical cutting blade disposed vertically in between the upper limb and the lower limb. Upper limb and lower limb extend distally beyond the cutting blade and have open slots to facilitate proper positioning and engaging of the tissue while allowing visualization of less routing structure. The knife receives the probe head of an endoscope just behind cutting blade for proper visualization and illumination. The guiding system comprises a handle unit and a pair of parallel guides with long open slots that act as a cannula of adjustable diameter. The open slots on parallel guides facilitate 360 degree visualization of the surroundings and also prevent derailing of endoscopic knife unit while passing through it.
