Classical lung cancer resection surgery is still performed by traditional open surgery, which is commonly referred to as “open surgery”, and this approach usually reveals clear, fixed steps, easy to perform, and easy to control in case of intraoperative accidents. In fact, in large medical centers in China, 60-70% of lung cancer patients currently undergo minimally invasive surgery. What exactly is the difference between open surgery and minimally invasive surgery? The difference mainly lies in whether a spreader is used to hold open the rib cage. Our thoracic cavity is surrounded by a hard bony chest wall, which includes the sternum in the front and the spine in the back, but more than 80% of the area is encircled by 12 ribs that are symmetrical from left to right. The ribs are arranged horizontally from front to back with a slight downward slope, and between each rib is a 1-2 cm rib space, and the vast majority of our thoracic surgery is done through the rib space into the chest cavity. Traditional open surgery requires a spreader to open the ribs above and below the intercostal space, exposing a window of more than 10 cm so that the operator’s instruments and palms can enter the thoracic cavity to perform the operation. Propping up the rib gap, which is only 1-2 cm wide, to a width of more than 10 cm inevitably displaces the ribs up and down. Although the ribs are connected to the spine and sternum by joints, these joints are relatively fixed and are not like a freely moving hinge, so the process of rib spreading under open surgery relies on the elasticity of the ribs themselves. However, in adults, especially in the elderly, when the rib cage is not flexible enough, the rib cage has to be damaged, including rib fracture and at least cortical damage, and sometimes we intentionally cut off a rib to reduce the scope of damage, but we still cannot avoid damage to the rib cage and intercostal muscles. Unlike minimally invasive lumpectomy, the operator’s arm is not required to enter the chest cavity. Through the camera and monitor, the view of the chest cavity can be cleaned and displayed in front of the operator’s eyes, while the surgical instruments all enter the chest cavity through tiny operating holes. The integrity of the bony chest wall is maximally protected, the patient’s postoperative recovery process will be significantly improved, the incidence of pain is significantly reduced, and the patient’s long-term quality of life is significantly improved. Of course some patients may be concerned whether lumpectomy will reduce the completeness of resection, but in fact for skilled minimally invasive surgeons, lumpectomy resection can be exactly the same or even better than open surgery. Another emerging minimally invasive surgical modality is “robotic surgery,” which was originally inspired by the U.S. military’s desire for remote surgery. Robotic surgery is also done under a monitor, but the biggest difference with traditional thoracoscopic surgery is that a robotic arm is used instead of a human arm, and the operator is directing the robotic arm from a controller under the operating table to complete the surgery. The image under the robot is 3D, which provides the operator with more accurate operation guidance, while traditional thoracoscopic surgery is two-dimensional, and the depth of the operating field depends on the operator’s experience. Theoretically, robotic surgery should have higher precision, especially for complex separation and suturing techniques, than conventional lumpectomy. However, robotic surgery is not yet widespread, and equipment and consumables are expensive, nearly one times more expensive than ordinary minimally invasive surgery. Therefore, cost reduction is the key to determine whether this technology will become popular.