Minimally invasive video-assisted thyroidectomy (MIVAT) was introduced in the clinical practice to treat small benign thyroid nodules. This method was also recently proposed in patients with Papillary Thyroid Cancer (PTC). In this lecture, Prof. Paolo Miccoli presents the indications of MIVAT, the results of his experience showing the advantages of this technique. He also discusses future developments such as the TOVAT procedure (Totally Transoral Video-Assisted Thyroidectomy) only performed in cadavers and pigs underlying his objections to this approach.