Traditional open thyroid surgery inevitably leaves a so-called “suicide scar” on the exposed part of the neck, which has a huge psychological impact on the patient’s subsequent life. With the economic development and improvement of life, the demand for minimally invasive and cosmetic surgery has increased greatly, and the application of lumpectomy technology has led to the rapid development of this field. There are many minimally invasive lumpectomy approaches for thyroid surgery, including neck approach, anterior small incision oral mirror-assisted approach, subclavian approach, axillary approach, axillary areolar approach, thoracic breast approach, complete areolar approach, retroauricular approach, submandibular approach, etc. These surgical approaches shorten or transfer the original long surgical incision in the neck to a relatively hidden part of the body, which has more obvious advantages, but still leave 1~4 small incisions on the human skin surface. However, there are still 1~4 small surgical scars left on the human skin surface. There are reports of lumpectomy of the thyroid gland through the floor of the mouth combined with the oral vestibule, but the floor of the mouth is only 5 mm as an observation hole and access for specimen removal, and there are difficulties in removing the specimen, serious postoperative swelling of the floor of the mouth, and high transit opening rate. In November 2011, Prof. Cunchuan Wang’s team successfully performed the first transoral vestibular cavity thyroid surgery in China and the world based on the characteristics of the flat mandible and the analysis of the anatomy of the oral vestibular area. Recently, Prof. Cun-Chuan Wang and his team performed the first endoscopic thyroidectomy using the oral vestibular approach (ETOVA) and endoscopic thyroidectomy by complete areola approach (ETAA) in China. The results of a prospective comparative study of endoscopic thyroidectomy using the oral vestibular approach (ETOVA) versus complete areola approach (ETAA) showed that transoral vestibular thyroidectomy is safe, feasible, effective, and has better cosmetic results. The results of this study were published in a recent issue of Surgery. Twenty-four patients with benign thyroid nodules were randomized to the ETOVA and ETAA groups to observe operative time, intraoperative bleeding, postoperative hospital stay, postoperative complications, and cosmetic outcomes. The surgery was successfully completed in all cases with complete resection of the lesion and no cases of intermediate open surgery. There was no significant difference in the operative time, intraoperative bleeding, postoperative hospital stay, and operative cost between the two groups. Postoperative follow-up showed no complications such as subcutaneous hematoma, effusion, superior or recurrent laryngeal nerve injury, or parathyroid gland injury in either group. patients in the ETOVA group had one 10-mm and two 5-mm surgical scars in the areola after surgery, whereas patients in the ETOVA group had no surgery-related scars on the neck or body, and patients in the ETOVA group had better satisfaction with the surgery. This study confirms that ETOVA is a safe and feasible procedure for Chinese patients with a flat mandibular chin, especially for most young patients with high cosmetic requirements. With the accumulation of experience, the update of surgical instruments and the expansion of the surgical scope, this approach will be more popular.