Endoscopy through the natural cavities of the human body for the diagnosis and treatment of certain diseases has reflected great advantages, the addition of robots may change the traditional mode of surgical operation, the spinal cord, cranial cavity brain, heart and other strives for fine application of certain complex surgery, bringing revolutionary progress, in the head and neck certain cavity parts of the tumor surgery does reflect the outstanding advantages. In the application of thyroid surgery, the addition of robotics, the flexibility of operation, three-dimensional vision and accurate simulation technology may partially solve and replace the limitations of the lumpectomy field, and therefore is overly enthusiastic. However, the current robots are still “machines”, not “people”. Under endoscopy, even robots can not replace two aspects under artificial cavity: one is the visual all-around situational awareness and judgment of tumor and its surroundings; the other is the tactile recognition of experienced oncologists’ fingers, which is precisely the detail to reduce the recurrence of certain tumors. Although many people define it as “minimally invasive” surgery, in the case of the thyroid gland in the neck, an artificial “cavity” of tissue needs to be created, which is in fact an “invasive” surgery. This cavity is contrary to the principle of adequate exposure required for tumor surgery. Surgical trauma includes anesthesia time, surgery time, and the extent of tissue damage, etc. The size of trauma to the patient is positively related to these factors, which is basic surgical knowledge. Similarly, the application of endoscopic techniques to head and neck oncologic surgery, especially in the neck, has been very controversial. This academic disagreement can be seen basically between oncologists and general surgeons or otolaryngologists, probably related to differences in professional background and philosophy of malignancy treatment. I have also had the privilege to observe several excellent endoscopic specialists throughout the combined radical thyroid cancer surgery, which was absolutely top-notch in lumpectomy technique and uneven in oncology treatment. Although many physicians have a lot of praise, from the oncology specialty point of view, there are large limitations in the treatment of many critical areas and more complex cases. In most hospitals in China, there are still not many physicians who master traditional neck clearance surgery in a standardized way, let alone under lumpectomy. From the available clinical practice results, it seems that the only advantage gained from robotic endoscopic use for thyroidectomy or radical surgery, including cervical lymph node dissection, is “hidden scar” cosmetic, and there is no clear evidence that oncologic results are equal to or better than conventional surgical approaches. There is no clear evidence that oncologic outcomes are equal to or better than conventional surgical approaches, and there is no shortage of cases where oncologic safety issues have been revealed. There is no doubt that traditional treatment methods can be improved, changed or even discarded. In the field of tumor treatment, we should actively advocate the application of advanced treatment concepts and new technologies, rather than resist them. The lumpectomy technology is well established, especially in the application of natural body cavity. The extension of lumpectomy to the treatment of thyroid cancer is a new technique in terms of surgical approach, but the promotion of it as an advanced technique should not only introduce the recent empirical techniques without focusing on the long-term oncological results. The current approach to validate whether a new surgical option is more effective or of greater benefit to patients is usually to use retrospective summaries of clinical case data, which mostly do not reflect the true situation. Whether advanced technology can deliver the same “advanced” oncologic outcomes, whether the overall patient benefit is better or equal to that of conventional open surgery, and which are more reasonable indications, all require more randomized clinical data for scientific evaluation and time and rigorous evidence-based medicine to prove. Any improvements and innovations should be aimed at maximizing the ultimate benefit to patients. When the MD Anderson Cancer Center planned a prospective pilot study in the 1980s randomizing 740 cases of early-stage cervical cancer to minimally invasive or robotic versus open abdominal hysterectomy, the initial investigators subjectively believed that minimally invasive radical hysterectomy outcomes should be equal to or better than conventional open radical surgery. The results harvested in recent years showed that minimally invasive resection had worse cure rates, confirming that patients undergoing robotic surgery had higher recurrence rates and worse survival rates. The results have changed the center’s choice of treatment for cervical cancer. In 2012, a comprehensive comparative study of robotic and endoscopic surgery for thyroid tumor removal in patients with similar conditions at St. Mary’s Hospital in Seoul, Korea, concluded that robotic and endoscopic thyroidectomy took longer and cost more, with no improvement in tumor prognosis or complication rates, and that the data did not support any advantage other than the high level of experience, similar to that of traditional thyroidectomy in head and neck oncology hospitals. method thyroid surgical resection takes an average of 40 minutes, with lower cost, complication and recurrence rate. Therefore, it is clear what method of surgical treatment of thyroid tumor is more beneficial to patients with a little understanding of the comparison. Exhibit: Comparison of events related to different modalities of surgery for thyroid tumors for similar conditions: From the viewpoint of the efficiency-cost ratio, the expensive cost increase is obtained to meet only some of the patients’ aesthetic needs, while the cost and technical requirements of their physician training and training are much more difficult than those of open surgery. There is nothing wrong with expanding the application of innovative technologies, but at this stage in our country, although the GDP is the second largest in the world, the uneven distribution of economic conditions is still a reality, and the consideration of medical costs and social benefits should not be ignored, at least for now, is not a better choice. Some individuals with strong or special aesthetic needs should also be fully aware of the possible risks, especially potential unknown oncological risks, before choosing this procedure, which is different from traditional open surgery, because after all, oncological safety is more important than cosmetic needs. However, one advantage should not be emphasized to the selective neglect of other practical issues. It is not simply a matter of asking thyroid surgeons to change their mindset, but “innovation” without a sound oncologic treatment philosophy and a solid oncologic treatment background is hollow and patients will not benefit more. Thyroid cancer is one of the malignant tumors with relatively slow development, less damage to the body, and good prognosis, and it is one of the tumors with good treatment effect. While there is still a need to further improve and enhance the outcome of thyroid tumor treatment, the excessive promotion of robotic lumpectomy as a method may just be “icing on the cake”. Should the relatively limited medical resources and funding be focused more on the hard-to-treat thyroid cancer population (about 5%)? Or should we focus more on those areas and groups with poor medical resources and conditions? Many tumors that are more dangerous to people’s health may need more “charitable” research and investment? Please share your views and opinions.