This review systematically elucidates the integrated treatment paradigm of Super Minimally Invasive Surgery (SMIS) for Gastrointestinal Cancer (GIC) based on the concept that "cancer is a systemic disease". The fundamental innovation of SMIS lies in shifting the treatment goal from traditional organ resection to lesion clearance with preservation of organ function, which is grounded in the reconceptualization of solid tumors as an aberrant organ composed of "tumor micro-spheroids". For early-stage GIC, precise patient stratification enables the identification of individuals at low risk of metastasis, allowing the application of SMIS techniques such as non-full-thickness or full-thickness resection to achieve local cure and organ preservation.In advanced GIC, the therapeutic rationale transforms: following tumor downstaging and systemic control via neoadjuvant therapy, SMIS is employed to eradicate residual drug-resistant lesions, thereby consolidating efficacy and preventing recurrence.This staged and individualized SMIS framework marks a significant transition in GIC management from traditional radical resection toward precise functional preservation.Future efforts should focus on overcoming technical bottlenecks such as precise lymph node dissection and multimodal efficacy evaluation, shifting the paradigm of lymph node management from "anatomic dissection" to "immunomodulation of the metastatic niche", promoting the evolution of SMIS from local treatment to comprehensive regional disease control, and ultimately achieving the dual optimization of oncological safety and quality of life.