In my usual work, I am often asked a question by patients and family members of bowel cancer patients: Doctor, is it better for me to have an operation? Or is minimally invasive surgery better? Patients and family members usually think like this: traditional open surgery is clean, but the incision is large and they are afraid of pain after surgery. Minimally invasive surgery has a small incision and fast recovery, but they are afraid that the incision will not be clean and will easily recur, so they are in a dilemma. Therefore, I want to write this article to give you some reference, here, I do not want to list so many boring and difficult to understand clinical research data, only want to use the big words, to explain the advantages and disadvantages of each. We are all familiar with traditional open incision, and countless bowel cancer patients have been treated in this way in the past, which is considered to be “clean” and has indeed stood the test of practice. However, people’s concern is the large incision and fear of pain. Especially for older patients, they are afraid to move around and cough after surgery because of pain, which causes complications such as venous thrombosis of lower limbs and pneumonia. Minimally invasive laparoscopic surgery is a new surgical approach that has emerged in the last decade or so, in which surgeons reach into the abdominal cavity to remove tumors by grasping specialized surgical instruments instead of the doctor’s hands. The more recent robotic surgery involves the surgeon reaching into the abdominal cavity with a computerized system to control the surgical instruments. After rigorous training and experience (both prerequisites must be emphasized), there is no difference in the “clean” results of laparoscopic surgery compared to traditional open surgery, as confirmed by relevant clinical studies. Moreover, because the incision is small and less painful, it is possible to get out of bed early, with fewer complications such as pneumonia and lower limb vein thrombosis, and recovery is naturally faster. The disadvantage is that the cost is relatively high, and the related disposable medical devices are not yet covered by medical insurance. The high price makes robotic surgery only carried out in a few hospitals in China. Therefore, one cannot simply say whether a particular method is good or bad, each has its own advantages and disadvantages. Patients should choose based on their financial ability and the surgeon’s experience, which may be more important. If this doctor is good at open abdomen, then it is more appropriate to choose open abdomen. As for the problem of post-operative pain, post-operative analgesic drugs, including analgesic pumps, are now well established, so post-operative pain is far from being as horrible as before. If this doctor is experienced in minimally invasive laparoscopic surgery, then you can choose laparoscopy, which has been more widely carried out in the colorectal specialties of tertiary hospitals. In short, choosing a doctor you know and can trust is the most important thing.