In a single-center randomized controlled trial of 90 patients with idiopathic carpal tunnel syndrome, mini-incision carpal tunnel release using the ProMIS kit resulted in faster early recovery compared with open release, with lower pain and better functional scores at 2 weeks and 1 month. Operative time was shorter and incision length smaller with the mini-incision approach, while complication rates were similar between groups. By 2 months, both groups showed substantial improvement, though several outcomes—including pain, PRWE scores, 2-point discrimination, and grip strength—still modestly favored the mini-incision technique, with overall functional differences narrowing.