A novel technique and product for carpal tunnel microscopic surgical procedures using a modified medical device containing a head as a surgical scalpel under light guidance were designed and studied. The novel design of the medical device was developed and applied in a new carpal tunnel microscopic surgical procedure in place of the traditional carpal tunnel surgical procedure. Biological and clinical evaluations of carpal tunnel surgical procedure using the designed optically guided medical device were studied. For commercialized reasons, some guidance was considered, such as ISO 10993-1:2009(E), for the biological evaluation of the device. Furthermore, a clinical evaluation was carried out. The designed optically guided medical device could provide a powerful medical device for carpal tunnel syndrome and related applications.