Middle lobe syndrome refers to right lung middle lobe atelectasis, lung lobe shrinkage or complication of inflammation due to bronchial lesion itself or compression and obstruction by extrabronchial enlarged lymph nodes, also known as Brock syndrome or Graham-Burford-Mayer syndrome. The bronchi in the middle lobe of the right lung itself is relatively slender, and after inflammation the middle lobe becomes more and more narrowed by compression causing recurrent infections in the middle lobe of the right lung, and the clinical manifestations are mostly recurrent fever, and the shadow in the middle lobe of the right lung is difficult to heal. In time, the middle lobe fibrosis becomes solid and loses its proper function, even causing malignant changes. Middle lobe syndrome is not rare, but in recent years the author has accumulated a lot of patients with middle lobe syndrome surgery, early this type of surgery is done with a large incision, but in the past two years is changed to thoracoscopic completion. It is quite a coincidence that three such patients were treated consecutively this week, and I have accumulated a wealth of experience in minimally invasive thoracoscopic treatment of middle lobe syndrome. Due to the long-term repeated inflammatory irritation in these patients, the adhesions in the thoracic cavity are often very heavy, and the lung fissures are often stuck together with no clear distinction between the upper and lower lobes. As a result, many thoracic surgeons shy away from attempting this type of surgery. I remember that in the earliest days when I attempted this type of surgery, it often took 4-5 hours to complete. Now, after a long period of honing and improving, this type of surgery can be done in only 1 hour. The postoperative status of the patient is significantly better than that of open surgery.