Pleural adhesion is a common problem in our clinic, but patients are often unaware of it. In the past, pleural adhesion was a relative contraindication to TV thoracoscopic surgery, which would directly affect the surgical field, increase the operation time and bleeding, and increase the difficulty of the operation. So, with the rapid development of medicine today, can patients with pleural adhesions complete surgery under TV thoracoscopy? First of all, we need to understand what is pleural adhesion. The so-called pleural adhesion is the adhesion of two layers of pleura together, which is caused by tuberculosis, pleurisy and chest injury. The reason is that there is often exudate fluid in the pleural cavity of these patients, and once the fibrin in the fluid deposits on the pleura, it will lead to the thickening of the pleura, and if the fibrin continues to deposit, the two layers of the pleura will gradually stick together. If the fibrin deposits continue, the two pleural layers gradually stick together, or if there is granulation in the pleural cavity, which can lead to thickening of the pleura to the point of adhesion. Pleural adhesions are very common, and some people have no symptoms, while others may experience chest pain. The basic requirement for televised thoracoscopic surgery is intraoperative lung atrophy to allow full exposure of the operative field. However, pleural adhesions can impede lung atrophy, and filamentous adhesion strips are scattered throughout the chest cavity like a spider’s web. The first priority is pleural adhesion release to separate the two layers of pleura that are stuck together. This relative contraindication is no longer a limiting factor for TV thoracoscopy as it continues to evolve and operators gain experience. Current TV thoracoscopes have a 30-degree wedge lens and can be rotated, giving a nearly 360-degree view. This gives TV thoracoscopy a visual advantage over open-heart surgery, and its magnification also allows the operator to see every blood vessel for complete hemostasis. Prof. Liu Hongxu and his assistants have completed a large number of televised thoracoscopic surgeries with pleural adhesions and have accumulated a wealth of experience. Televised thoracoscopic radical lung cancer surgery with extensive pleural adhesions can be accomplished with an incision of 3-5 cm, and rarely extends the incision due to pleural adhesions. All patients recover well after surgery and are usually encouraged to move out of bed on the first postoperative day. Of course there is a slight increase in operative time, but it is worth the effort when compared to the speedy recovery that patients are able to make after minimally invasive surgery.