Ideally, minimally invasive surgery (MIS) allows less extensive manipulation of surrounding tissues than a conventional open procedure while accomplishing the same goals and objectives at the target structure. Long-term follow-up combined with appropriate outcome measures are necessary to prove the safety and effectiveness of MIS. For MIS procedures to be widely adopted, they must have an acceptable learning curve. Special skills are needed and are beyond those of traditional open surgery, By definition, as compared with conventional open surgeries, minimally invasive procedures typically involve smaller incisions and less extensive surgical manipulation of the tissues that surround the target structure. Ideally, once the target structure has been reached, the minimally invasive procedure should accomplish the same goals and objectives as its open surgical counterpart. Thus, although minimally invasive surgeries are aimed at reducing the morbidity associated with open surgical approaches, they should not hinder the surgeon’s ability to perform a successful operation. In other words, minimal invasion should not equate to minimally effective.