  In this article, we extend the mean curvature flow with surgery to mean
convex hypersurfaces with entropy less than $\Lambda_{n-2}$. In particular,
2-convexity is not assumed. Next we show the surgery flow with just the initial
convexity assumption $H - \frac{\langle x, \nu \rangle}{2} > 0$ is possible and
as an application we use the surgery flow to show that smooth $n$-dimensional
closed self shrinkers with entropy less than $\Lambda_{n-2}$ are isotopic to
the round $n$-sphere.
