Minimally invasive is a comparison with traditional surgery, i.e., small incision, short operation time, less bleeding, and fast postoperative recovery of the patient. Lumpectomy has been performed in many systems or organs. However, the mention of lumpectomy does not equate with minimally invasive. Or does the absence of lumpectomy mean that there is no minimally invasive surgery? There are three methods in thyroid surgery, namely the traditional method, the lumpectomy (scarless neck) method, which is the more invasive and cosmetic procedure. Then there is the minimally invasive technical condition of thyroidectomy which includes lumpectomy assisted thyroidectomy and small incision thyroidectomy under direct vision. In the third surgical approach the main role is really played by the high-powered ultrasound knife, while the lumpectomy does nothing more than magnification and illumination. Minimally invasive surgery that can be done under direct vision eliminates the need for a lumpectomy and the expense it entails, when the same procedure is performed in the same incision and at the same site. In my practice, I have found that the use of ultrasonic knife surgery under direct vision saves surgical preparation time, which is equivalent to reducing the patient’s stay on the surgical bed, and also reduces the patient’s lumpectomy cost ($1000). Most of the surgery is done with local anesthesia, less bleeding, shorter surgery time, 2.5-3 cm incision, and faster patient recovery. It is a cost-saving minimally invasive surgery.