The size of the cardiac surgical trauma is not only the incision but also the length of the extracorporeal circulation time and the satisfaction of the cardiac lesion repair. If the surgical exposure is poor, the incision alone is small while the extracorporeal circulation time is long and the cardiac lesion repair is not perfect, this minimally invasive procedure is not worthwhile. The significance of this incision reduction is even more insignificant compared to the difference in quality of life of the patient 20-30 years after surgery and the risk of reoperation. Perfect repair of a lesion that can be repaired, or perfect implantation of a prosthetic valve that is as large as possible when repair is not possible, is far more significant than a smaller chest wall injury. A coronary patient needs four bridges to perfectly resolve myocardial ischemia, because the actual quality of the procedure is significantly reduced by the use of small incisions, poor field exposure, only 2-3 bridges, and poor quality anastomoses. In foreign countries, the premise of minimally invasive surgery is not to reduce the degree of perfection of the heart repair. Unlike general thoracic surgery, which is reconstructive (e.g., repair of mitral leaflet prolapse), the vast majority of thoracic surgery is destructive (e.g., lung cancer resection), so the requirements of cardiac surgery are much higher than those of thoracic surgery, and thoracoscopic surgery, which is currently widely performed in general thorax, cannot meet the requirements of cardiac surgery. In the case of poor surgical field exposure, minimally invasive surgery has high demands on the surgeon’s skills, extracorporeal circulation line equipment and specialized surgical instruments.