”This surgery open, minimally invasive can be done, each has its advantages and disadvantages …… you need to make a choice”, when the rigorous doctor, supplying the affected party to choose, patients and families without a medical background often after listening to a long time doctor’s explanation, or difficult to make a choice,. Or choose a choice that is not very appropriate. They often choose “open surgery is good, clean and low cost”, “minimally invasive is good, minimally invasive, less traumatic”, “I don’t know how to choose”. That said, since the 1980s, from traditional open surgery to the introduction of extracorporeal shock wave lithotripter and cystoscopy, in the last 10 years, urology technology has made five great leaps: electrosurgery, ureteral rigid and flexible mirror, laparoscopy, and robot-assisted laparoscopy. And today, minimally invasive urological techniques have begun to show refinement, standardization and rationalization. First of all, urinary cavity surgery, urinary system stones, unless need to do deformity correction, currently can do 100% cavity surgery, kidney and upper ureteral stones can be done by percutaneous nephrolithoscopy, stones in the lower and middle ureter can be done by ureteroscopy, stones in the upper urinary tract with smaller stones can also be done by ureteral flexible mirror. Bladder stones can be done by transurethral bladder stone lithotripsy. Prostate enlargement surgery: transurethral electrodesiccation of prostate, plasma electrodesiccation, prostate enucleation can be done, early bladder tumor: transurethral bladder tumor electrodesiccation can be done; vesiculitis: vesiculoscopy can be done. Secondly, laparoscopic surgery, treatment of adrenal, kidney, ureter, bladder and prostate tumors, partial resection to total resection, surgeries that used to require open surgery can now be basically solved by laparoscopy, such as posterior laparoscopic resection of adrenal tumors, posterior laparoscopic nephrectomy, kidney tumor resection; laparoscopic total bladder resection, total ureter resection, radical prostatectomy and so on. In addition, the introduction of the da Vinci robot is a new era of laparoscopy. Once again, even for the small percentage of open surgery, the incisions are getting smaller and more delicate, such as the best globally recognized procedure for varicocele: microscopic high level ligation of the spermatic vein. In short, the incision is getting smaller, the field of vision is getting clearer, the surgery is more precise, and the postoperative recovery is getting faster. Urology has entered the minimally invasive era. How should I choose between open and minimally invasive surgery? The answer is: if the doctor tells you that minimally invasive surgery is possible, don’t hesitate to choose minimally invasive surgery. If you are told that minimally invasive surgery is difficult and open surgery is better, choose open surgery.