Thoracoscopy has been in clinical use for more than 80 years, and in the late 1980s, with the rapid development of optical technology, high-tech television and endoscopy were combined to produce a new surgical method in the field of thoracic surgery – television thoracoscopic surgery (Videothoracoscoplcsurgery or Videoassistedthoracicsurgery (VATS). This new surgery is performed with endoscopic instruments for certain diseases of the chest through a thoracoscope under a monitor display. With the aid of a thoracoscope and television images, surgeries that used to require large incisions can be performed with only a few small incisions. With the rapid development of fiber-optic technology, high-definition imaging systems, high-tech endoscopic surgical instruments and anesthesia monitoring, modern thoracoscopic surgery has a wider field of view and clearer images than traditional thoracoscopic techniques. Its scope of application has also changed from the traditional diagnostic-based to a novel surgical technique with a therapeutic focus. It has the advantages of small trauma, aesthetics, fast postoperative recovery and short average hospitalization days, which are incomparable to ordinary open-heart surgery. Advantages of thoracoscopic surgery: 1. Small surgical trauma: ordinary open-chest surgery is very traumatic, with an incision of 25cm or more, serious chest wall damage, severing the chest wall muscles of all layers, and also forcibly propping open the intercostal area of 10-20cm, which makes postoperative pain difficult to resolve. Thoracoscopic surgery is generally completed by making three small 1.5cm long incisions in the chest wall. Some difficult cases need auxiliary 5-10cm small incisions, but it is not necessary to forcibly open the intercostal space. 2, postoperative pain is light: ordinary open chest surgery due to chest wall trauma, more than a week after surgery to get out of bed, chest pain can last for months to years, most of the loss of physical labor ability. After thoracoscopic surgery, patients can get out of bed within 24 hours, and can participate in physical activities 2-4 weeks after surgery. 3.Less postoperative complications, safer for elderly patients. 4.Aesthetic, small wound, most patients are happy to accept it. 5.Fast recovery and short hospitalization time. Indications for TV thoracoscopic surgery: 1. Diagnostic surgery indications: It can be applied to the diagnosis of a variety of thoracic diseases including pleural, pulmonary, mediastinal and pericardial diseases as well as thoracic trauma. It can be clearly displayed on the TV, photographed and videoed, and histopathological examination can be obtained. 2. Indications for therapeutic surgery: ① pleural diseases: abscess chest, pleural mesothelioma, metastases, trauma hemostasis, pneumothorax, benign and malignant pleural effusion, etc. ②Pulmonary diseases: resection of benign lung masses, lung reduction in some lung cancer patients and end-stage emphysema. ③Esophageal diseases: esophageal smooth muscle tumor, esophageal diverticulum, cardia incontinentia, early esophageal cancer. ④Mediastinal diseases: mediastinal tumors less than 5 cm, mediastinal cysts. ⑤ Other: hand sweating, celiac disease, cardiopulmonary trauma. Thoracoscopic surgery has revolutionized thoracic surgery, but there are still many problems that need to be solved. In the diagnosis and treatment of many benign diseases and malignant diseases, thoracoscopic surgery is undoubtedly an excellent treatment modality, better in terms of patient pain, recovery and wound aesthetics, and with the right patient selection, the results are comparable to those of general open-heart surgery. In the treatment of malignant diseases, especially radical resection surgery, it is still appropriate to select patients carefully to avoid adverse consequences.