Minimally invasive is the trend of surgical development in this century, and it is also a proposition how to perform minimally invasive transformation of thyroid surgery. In recent years, the number of reports on endoscopic thyroid surgery at home and abroad has gradually increased. Actually, it is not. For example, the multi-incision remote tunneling CO2 gas chamber type of endoscopic thyroid surgery (areola-anterior sternal pathway or axillary pathway), which is currently being performed, has the advantage of being cosmetic rather than minimally invasive. Another type of endoscopic thyroid surgery assisted by a small incision mechanical lift chamber (Miccoli procedure) is less invasive and more in line with the minimally invasive concept, first proposed by the Italian surgeon Miccoli in 1997. The basic framework is a single 1-2 cm incision in the anterior lower neck, with a slight incision in the midline, and then a mechanical lift to create a cavity directly under the zoster muscle, followed by a microscopic view. The highlight of this procedure is the use of endoscopic “peek-a-boo” and magnified imaging to partially replace direct visualization, and the resulting drastic reduction of the incision and elimination of flaps. This procedure significantly reduced operative trauma and reduced incisions in the neck, resulting in a true aesthetic improvement with minimally invasive surgery. At that time, its surgical scope was generally limited to benign thyroid tumors of 2.0 cm in diameter and below. In 2004, the Chinese Journal of Surgical Theory and Practice named it the “Miccoli technique”, and in 2006, the Chinese Journal of Surgery also adopted this name. We were the first to perform “modified Miccoli endoscopic thyroid surgery” in the Changwu area. A 2.0-2.5 cm surgical incision is made in the anterior sternal fossa of the neck, the banded muscle flap is freed, the cervical white line is opened, and a 30° wide-angle rigid microscope (Storz, Germany) with a diameter of 5 mm and a length of 29 mm is used to create a cavity between the true and false tegument of the affected thyroid gland. Since the endoscope itself is a well-lit light source and the microscopic field of view is 4-6 times larger than the conventional field of view, the retrograde laryngeal nerve and parathyroid glands can be effectively exposed and protected during the procedure. At the same time, we use the Johnson & Johnson ACE ultrasonic knife to effectively dissect the upper pole of the thyroid gland without ligation, using the “free – migrating coagulation – dissection method” to achieve a bloodless operation. Then, after dissecting the inferior pole vessels and the middle vein under direct vision, the thyroid is dragged out of the incision and the subsequent steps are completed under direct vision. We have routinely performed many standard lumpectomy-assisted radical thyroid cancer, thyroid lobectomy, and major thyroidectomy using the modified Miccoli procedure. This procedure is a minimally invasive thyroid surgery in the true sense of the word, utilizing our existing instruments and equipment and significantly reducing the incision in the neck (from 4.0-6.0 cm to 2.0-2.5 cm) without affecting the outcome of the surgery. It also eliminates the need for hospitals to purchase new instruments and equipment, saving costly expenses and patient medical costs.