Total thoracoscopic radical lung cancer treatment is an emerging technique in the field of lung cancer treatment and is an important part of minimally invasive thoracic surgery. Micro-trauma thoracic surgery is a concept and philosophy that relies on modern technology to minimize the trauma that occurs in the chest wall approach while the lesion is treated intra-thoracically as thoroughly as the traditional open chest, so that the trauma and damage to the patient’s organism and the function of each system are minor; it mainly involves anesthesiology, anatomy, pathology, ergonomics, etc. Surgical method: The operation is performed with double-lumen tracheal intubation, intravenous complex anesthesia, ventilation of the healthy lung, atrophy of the affected lung, 90-degree prone position on the healthy side, folded knife position, and the upper limb on the affected side suspended abductively from the head frame. The four-hole incision layout is as follows: main operating hole: 3 cm between 4 ribs in the anterior axillary line; secondary operating hole: 1 cm between 6 ribs in the subscapular line, 1 cm between 9 ribs 2 cm posterior to the posterior axillary line; lumpectomy hole: 1 cm between 7 ribs in the mid-axillary line. The lungs are dissected from the most superficial structures in the soft tissues of the hilum, and the lobes are dissected and dissected sequentially, from front to back for resection of the upper and middle lobes, and from bottom to top for resection of the lower lobes, and finally the lung fissure is treated. The middle and lower lobes were resected first, followed by the lower lobes. All patients underwent systemic lymph node dissection, including 6 groups of lymph nodes, 3 from intrapulmonary (lobar, interlobular or segmental) and hilar lymph nodes and 3 from mediastinal lymph nodes including the inferior ramus lymph nodes. Surgical features: sequential dissection (defined as unidirectional in China) and systematic lymph node dissection. Sequential dissection: right upper lobe resection: upper pulmonary vein – superior pulmonary artery trunk (first branch) – upper lobe bronchus – posterior segment artery – pulmonary fissure right middle lobe resection: middle lobe vein – middle lobe bronchus – middle lobe artery – pulmonary fissure -Middle lobe artery -Pulmonary fissure Right lower lobe resection: lower lung vein -lower lobe bronchus -lower lobe artery -Pulmonary fissure Left upper lobe resection: upper lung vein -upper lobe bronchus -branches of upper lobe arteries -pulmonary fissure Left lower lobe resection: lower pulmonary veins -lower lobe bronchi -lower pulmonary arteries -pulmonary fissure Right middle and lower lobe resection: middle lobe resection -lower pulmonary veins -Systemic lymph node dissection: Right side dissection of mediastinal lymph nodes in groups R2, R4, 7, 9 and hilar and interlobular and intralobar lymph nodes in groups 10, 11, 12. The left side was cleared of mediastinal lymph nodes in groups L4, 5, 6, 7, 9 and hilar and interlobular and intralobular lymph nodes in groups 10, 11, 12. Through clinical application, we appreciate that 1. sequential total thoracoscopic lobectomy has the following advantages (1) it avoids the anatomical difficulties caused by the separation process of lung fissure hypoplasia and postoperative air leakage from the lung trauma; (2) sequential anatomical separation, from superficial to deep, is relatively safe to deal with from surface to inside, avoiding bypassing one structure to deal with another and reducing the risk of major bleeding; (3) the sequential concept is applied to central lung cancer requiring right middle and lower lobe resection can replace the more traumatic conventional open-heart surgery.2. The magnification of lumpectomy can better display fine structures when performing systemic lymph node dissection, resulting in a greater number of lymph nodes dissected, more accurate pathological staging, and more accurate postoperative standardized treatment plan, making patients truly benefit from surgical treatment.