Microsurgical carpal tunnel release uses the mini-open surgical approach with the use of microsurgical techniques. The microscope provides magnified visualisation and a neurosurgeon versed in microsurgical techniques for peripheral nerve surgery uses fine microsurgical instruments to perform the surgery in a very delicate and safe manner under direct visualisation of the carpal tunnel and median nerve. Microscopic mini-open carpal tunnel release can be particularly useful in severe and difficult cases of carpal tunnel syndrome. It is also beneficial in patients who continue to have carpal tunnel syndrome after initial carpal tunnel surgery (e,g, from incomplete carpal tunnel release after endoscopic surgery) and patients who have developed a recurrence of carpal tunnel syndrome. Patients generally return to work early. Most patients show significant improvement in numbness, pain, weakness of the hand. Microsurgical carpal tunnel release is thought to be safer and usually more cost-effective than endoscopic carpal tunnel release.