Thyroid tumors tend to occur in young women. “Who doesn’t understand women’s love for beauty? However, traditional thyroid surgery leaves a long scar on the patient’s neck, especially for patients with scars, neck surgery is like a nightmare. The lumpectomy thyroid surgery, on the other hand, can provide the best of both worlds. The laparoscopic thyroid surgery is a method of removing the thyroid gland using laparoscopic technology. This surgery involves making three small incisions, only 5-10 mm in diameter, in hidden areas of the chest to remove the thyroid gland and its tumor laparoscopically. In this way, surgical scars on the exposed area are avoided and a safe and effective treatment is ensured, achieving an aesthetic result with no surgical scars on the neck. The patient can be discharged from the hospital in 3-5 days after surgery. Because of the complex and delicate local anatomical relationship of the thyroid gland and its proximity to important organs such as the trachea, esophagus and large blood vessels in the neck, as well as important nerves around it, plus the fact that the surgery is performed percutaneously and the surgical space is small, this requires the surgeon to have not only extensive experience in traditional thyroid surgery, but also skilled endoscopic surgical operation techniques. General endoscopic thyroid surgery is indicated for: 1) simple goiter where conservative treatment is not effective; 2) nodular goiter or cystic hyperplasia; 3) thyroid adenoma; 4) primary or secondary hyperthyroidism up to degree II. It can also be used selectively for differentiated thyroid cancer with small primary foci. Partial thyroid lobectomy, lobectomy, subtotal thyroidectomy, bilateral subtotal thyroidectomy, total thyroidectomy and lymph node dissection in the central region of the neck have been carried out in clinical practice. Advantages and disadvantages of each surgical route: 1. Areolar route The advantage is that the incision is not in the neck and the cosmetic effect is good. The disadvantage is that it is far from the lesion and requires more free flaps, which is more traumatic. 2. Axillary pathway The advantage is that the incision is the most concealed and the cosmetic effect is the best. The disadvantage is that it is far from the lesion, which is more traumatic; it is difficult to deal with the contralateral lesion. 3.Sternotomy pathway/subclavian pathway The advantages are that it is closer to the lesion and does not require too many free flaps, which is less traumatic; it allows lumpectomy-assisted thyroid surgery and is more suitable for beginners. The disadvantage is that the skin in front of the neck still leaves a small incision scar, and the cosmetic effect is poor. 4.The sternocostal path Compared with the sternotomy path, the incision is hidden and the cosmetic effect is good; compared with the areola path, there is no need to free the flap too much, the trauma is smaller and the same satisfactory cosmetic effect can be achieved. This is currently a mainstream approach. Complications Due to the magnification of the endoscope, the anatomical structures are clearly displayed during surgery, so that the incidence of traditional thyroid complications such as intraoperative vascular bleeding, injury to the recurrent laryngeal nerve, misincision of the parathyroid gland, and tracheal injury are no different or even lower than those of traditional surgery. have shown that when CO2 perfusion pressure exceeds 15 mmHg, it is likely to cause extensive and severe intracranial pressure elevation, subcutaneous emphysema, and even mediastinal emphysema, which in turn affects respiratory and circulatory function and leads to acidosis and hypercapnia. If there is a large vascular injury, gas embolism may also occur. In addition, the scope of subcutaneous separation is larger, and the trauma to the body is greater than that of traditional thyroid surgery. Improper separation can easily enter the subcutaneous fat layer by mistake and damage the small blood vessels and even the dermis, which can easily lead to fat liquefaction, skin bruising, redness and swelling after surgery and slow recovery. The key to avoiding and reducing complications is to master the anatomical structure of the thyroid gland, traditional resection and lumpectomy techniques. Controlling the appropriate CO2 perfusion pressure is the key to reducing CO2 perfusion complications, and it is generally believed that a perfusion pressure of less than 10 mmHg is effective in reducing the occurrence of complications. In addition, some patients may experience skin tightness and discomfort in the neck and chest for a period of time after surgery, which does not require special treatment and usually disappears gradually after 3 months. Surgical safety and results The ultrasonic knife’s ability to directly coagulate and cut blood vessels below 3 mm and the absence of heat conduction effect as well as the magnification of the lumpectomy can clearly identify the nerve and vascular structures, providing a safe and reliable guarantee for lumpectomy thyroid surgery. Miccoli et al. summarized the data of 336 cases of lumpectomy thyroid surgery, with a 4.5% turnaround rate and no difference in complication rate with conventional surgery. Wang Cunchuan et al. summarized the data of 169 cases of lumpectomy thyroid surgery, with a complication rate of 6.5% and a turn-around rate of 3.6%. The tumor was too large and the operating space was not enough; intraoperative visual observation highly suspected thyroid cancer or rapid pathological confirmation of thyroid cancer and serious adhesions between the tumor and the surrounding tissues; intraoperative causing uncontrollable bleeding were the main reasons for turning on the thyroid surgery. With the improvement of surgeon’s technique and the use of ultrasonic knife, laparoscopic thyroid surgery has become very safe and postoperative complications are very rare. Laparoscopic thyroid surgery is safe for skilled laparoscopists. Problems and Prospects Laparoscopic thyroid surgery should first ensure at least the same therapeutic effect as traditional surgery, and on this basis, pursue to minimize or conceal the surgical scar to achieve cosmetic purposes, so the current indications for the surgery should be strictly controlled, and not unilaterally pursue cosmetic and minimally invasive and ignore the therapeutic effect, which is putting the cart before the horse. There are still some shortcomings in lumpectomy thyroid surgery: 1, the site and nature of the lesion cannot be determined by palpation in lumpectomy thyroid surgery; 2, the operating space established in lumpectomy thyroid surgery is very narrow, requiring the surgeon to have skilled lumpectomy skills. The technical difficulties and dangers of lumpectomy for hyperthyroidism, including uncontrollable blood leakage, ischemia of preserved thyroid tissue, parathyroid gland damage, nerve damage and permanent hypothyroidism, as well as the difficulties of cervical lymph node dissection and the conformity of this procedure to oncological principles, make it difficult to promote lumpectomy for these two thyroid diseases, and further improvement of technology, improvement of instruments, and follow-up studies of a large number of cases are needed. Further technical improvement, improvement of instruments, follow-up studies of large number of cases and basic research are needed to solve these problems. It is believed that with the maturation of lumpectomy technology and the development of special instruments, lumpectomy thyroid surgery will become more popular and more patients will request lumpectomy thyroid surgery, and the indications for lumpectomy thyroid surgery will gradually expand, with several lumpectomy thyroid surgeries co-existing in the near future. The lumpectomy thyroidectomy will be more widely used to benefit more patients.