Minimally invasive concept of thyroid surgery Surgery is a medical discipline that treats diseases mainly through surgery, and surgery will inevitably cause certain trauma while treating diseases. Minimizing the trauma caused by surgery is a goal that surgeons have been pursuing for a long time. The concept of minimally invasive is not only to reduce the size of the incision, but also to strive to maintain the patient’s optimal internal environment in a stable state, to minimize trauma to tissues and organs, to minimize systemic inflammatory response, and to achieve the best scar healing, so as to achieve the best medical results. The thyroid gland is the endocrine gland with the highest morbidity rate in the human body, and the diseases are complex and mostly occur in middle-aged and young women. Due to the special location of the thyroid gland, which is located directly in front of the neck, traditional thyroid surgery will leave a surgical scar of about 5-10 centimeters in length on the neck. Although the suture method of cosmetic surgery has been borrowed in recent years, it is still unavoidable to leave a scar on the neck due to the patient’s skin quality, local inflammatory reaction and other individual differences. Through the concept of minimally invasive surgery, using different paths and methods from traditional surgery, under the premise of guaranteeing or better than the efficacy of traditional surgery, the incision in the neck is reduced and moved downward, hidden to the chest and other hidden parts of the body, and the neck can not be seen in the surgical scars. In recent years, a variety of difficult surgical procedures such as total laparoscopic radical treatment of standard gastric cancera, D2 lymph node dissection, hepatic hilar lymph node dissection, special hepatic segmental resection, hemihepatectomy, total laparoscopic pancreatic body-cail resection with preservation of the spleen, total laparoscopic gastric cancer radical treatment, cavity-assisted radical treatment of gastric cancer, total laparoscopic colorectal cancer radical treatment, and total laparoscopic splenectomy, etc., have been carried out, and furthermore, the neck is completely scarless and completely Laparoscopic thyroid surgery, incorporating laparoscopic minimally invasive surgical techniques into thyroid surgery, now we will briefly introduce some relevant information about minimally invasive thyroid surgery to you. I. Choice of incision and establishment of operating space There are more choices of incision positions and approaches for neck scarless complete laparoscopic thyroid surgery, and the ones that have been applied more often include neck approach, chest wall approach, areola approach, axillary approach, and submandibular approach, etc. The various approaches have their advantages and disadvantages. Each approach has its own advantages and disadvantages and scope of application, and is closely related to the operating experience of the surgeon. Second, the indications for complete laparoscopic thyroid surgery and the choice of surgical methods At present, the definition of the indications for minimally invasive thyroid surgery is still controversial, and the first choice is unilateral thyroid cases with preoperative findings suggesting the possibility of benign lesions. Currently, partial thyroidectomy, lobectomy, subtotal resection, and total resection can be accomplished by complete lumpectomy techniques. Even for larger thyroid lesions of 5-175px, they can still be removed by minimally invasive surgery. With recent technological advances, thyroid cancer is no longer a contraindication to minimally invasive totally lumpectomy thyroid surgery, and early cases without localized infiltration or lymphatic metastasis can be treated by minimally invasive means. For the successful completion of lymph node dissection in the lateral neck region, advanced thyroid malignancies with local infiltration or lymph node metastasis can also be successfully treated with functional neck-clearance surgery by complete laparoscopic techniques. The clearer contraindications to minimally invasive thyroidectomy are: mass diameter >8 cm, thyroiditis, history of previous neck surgery or radiotherapy, and severe obesity. As technology continues to improve, these indications, which currently appear to be absolute contraindications, may no longer be limiting cases for minimally invasive thyroidectomy. C. Comparison between minimally invasive thyroid surgery and traditional surgery Compared with traditional surgical methods, minimally invasive thyroid surgery can result in a scarless neck or, a better cosmetic outcome of the surgery. Considering that the high incidence of thyroid disease is mainly among young and middle-aged women, the presence of scars often causes great psychological trauma to patients and affects their normal social interaction activities after surgery. The development of medicine has now become increasingly concerned about the impact of disease treatment on human psychological and social factors, and from this point of view, the emergence of minimally invasive thyroid surgery will undoubtedly be of tremendous benefit to the patient’s psyche. As for actual tissue trauma, modified thyroidectomy is significantly less invasive than traditional thyroid surgery in terms of the extent of tissue separation and the degree of damage to normal tissue. Minimally invasive thyroid surgery also has its drawbacks, in order to narrow the incision, hide the incision, minimally invasive thyroid surgery often exists in the surgical process auxiliary miscellaneous, long operation time, high degree of reliance on high-tech medical equipment, special surgical equipment, the shortcomings of the high cost of the operation, and the operating surgeon, assistants have put forward a higher demand for the operating doctor, the surgeon must have a clear anatomical basis, skillful surgical techniques and cope with the accident in the surgery of the The surgeon must have clear anatomical foundation, skillful surgical technique and ability to cope with intraoperative accidents. As for the problem of surgical complications, according to the reports available so far, minimally invasive surgery is not significantly different from traditional thyroid surgery in terms of laryngeal reflux, supraglottis, and parathyroid gland injury. Some reports are even lower, probably thanks to the magnifying effect of endoscopy and the application of high technology such as nerve recognition system and ultrasonic knife. Fourth, the choice of surgical methods The use of which means of treatment of patients depends on both the doctor’s own technical level, but also related to the actual situation of patients, different people have different habits of dress, the cosmetic effect of the surgery has different requirements, different diseases, the prognosis of the surgery can be a big difference in the differences in economic conditions also affects the choice of surgical methods for different patients, the choice of surgical methods for different patients. For different patients, the choice of surgical methods should be individualized and specific, in order to bring the most satisfactory results to the patients without affecting the therapeutic effect. V. Outlook Minimally invasive is the current direction of surgical development. Due to the location of the thyroid gland, the pursuit of cosmetic results has become one of the most important driving forces for minimally invasive thyroid surgery, and the continuous progress of new endoscopic techniques, new technologies and equipment can be transplanted to thyroid surgery, which can bring more benefits to patients. On the basis of extensive experience in laparoscopic surgery and hundreds of thyroid surgeries every year, Dr. Qiu Weihua’s team has carried out scarless complete laparoscopic thyroid surgery of the neck, which has resulted in less injury, quicker recovery, and satisfactory results compared to traditional surgery.