In recent years, laparoscopic surgery has become very popular among patients because of small surface wounds, less bleeding and shorter hospital stays, and is often specified as minimally invasive surgery. Is laparoscopic surgery truly “minimally invasive” compared to conventional surgery, except for the small incision? Laparoscopic surgery requires general anesthesia and a pneumoperitoneum. CO2 pneumoperitoneum and hypercapnia during laparoscopic surgery, the respiratory circulatory effects of artificial pneumoperitoneum pressure, and the effects of pneumoperitoneum on renal hemodynamics should all be taken into account. In addition, some doctors aim to complete the laparoscopic surgery, ignore the patient’s specific situation, and reluctantly do it with improper selection of indications, resulting in excessive surgical difficulty, prolonged delay in surgery, and even conversion to open abdomen, which is very costly, increases the harm to the patient and affects the long-term results. Minimally invasive surgery is not the same as simple “small incision surgery”, it has a deeper meaning than simple small incision. Minimally invasive is a concept, a principle, and not exclusively a surgical approach or procedure such as laparoscopy. To achieve the best results with the least damage is the purpose of minimally invasive. Therefore, regardless of any kind of surgery, the surgeon should try to give the patient the least invasive procedure with less bleeding and faster recovery. This principle should permeate all surgical modalities. Pursuing the effect of the small incision left on the belly by laparoscopic surgery while ignoring the characteristics and general rules of the disease itself may be a very blind and dangerous act for the patient.