Globally, it has been 20 years since the first laparoscopic thyroid surgery was performed in 1996. Its indications have expanded from early benign thyroid diseases to differentiated thyroid cancers, especially the micropapillary thyroid carcinoma (PTMC). With the advancement of surgical techniques and accumulation of experience, the indications for complete endoscopic thyroid surgery are constantly broadening. 1.Difference between laparoscopic surgery and open surgery Laparoscopic surgery refers to the use of special surgical instruments, including high-definition visualization probe, various grasping forceps and energy instruments, to achieve the purpose of removing the diseased thyroid gland through the approach of a small hidden incision. Therefore, the biggest advantage of the surgery is that it leaves no visible scar on the neck. This avoids the need for open surgery, which leaves a visible scar of about 5cm on the patient’s neck that cannot be hidden. With reasonable surgical treatment, patients can achieve long-term survival after surgery, with a 10-year mortality rate of <1%.PTMC is most common in young women, and the cosmetic requirements and quality of life of patients must be considered while curing PTMC. Therefore, some scholars believe that PTMC is the best indication for laparoscopic thyroid surgery. Identification and protection of tissues under luminal microscope Luminal microscopy can magnify the operation field several times with the help of high-definition visual lens, and display it on the monitor in an all-round, dead-angle-free, and close distance, so that tissues such as the trachea, parathyroid glands, and laryngeal reentry nerves can be clearly observed. The use of laryngeal nerve monitor during the operation can minimize the accidental injury of the laryngeal nerve. The radicality of thyroid surgery Many patients worry that thyroid cancer can not be removed cleanly through lumpectomy. Lumpectomy has its scope of application. In any surgery, the scope of surgical resection is determined by the invasion range of the disease itself. There is an expert consensus and guideline to regulate the scope of resection, which has nothing to do with the type of surgery. 4, the contraindication of thyroid cavity surgery is usually considered an absolute contraindication: (1) no cosmetic requirements. (2) Suspected distant metastasis. (3) Tumor invasion of the recurrent laryngeal nerve (RLN), trachea and esophagus. (4) Postoperative recurrence. (5) Metastatic lymph nodes located below the level of the clavicle. (6) Cystic degeneration of the metastatic lymph nodes. Relative contraindications are: (1) History of neck surgery or radiotherapy. (2) Male. (3) Excessive obesity. (4) Combined Hashimoto's thyroiditis. (5) Metastatic lymph nodes with a maximum diameter of >2 cm.