Many heart conditions require surgical solutions. Cardiac surgery has become increasingly understood by everyone. However, traditional cardiac surgery mostly uses open-chest osteotomy, which is very traumatic, causes a lot of blood loss, is painful for a long time, and leaves huge scars on the chest. Because of the long surgical incisions, huge surgical risks, complicated surgical techniques, and slow post-operative recovery, people often talk about cardiac surgery with fear and shyness. Due to the improvement of living standards and economic conditions, people’s demand for surgery is getting higher and higher. Minimizing patient trauma and pain while ensuring the efficacy of surgical procedures is one of the goals that doctors must pursue. With the advancement of science and technology, cardiac surgery has evolved greatly. The traditional surgical approach has a large incision trauma, affects respiratory function and cosmetology, has many postoperative complications, and causes a lot of pain to the patient. Cardiac surgeons have changed this status quo after decades of exploration, and minimally invasive cardiac surgery was born out of this in response to the trend of the times. Thoracoscopic cardiac surgery is a newly developed minimally invasive surgical method. It is very different from conventional open-heart surgery. It is a new minimally invasive cardiac surgery technique that uses modern TV camera technology and high-tech surgical instruments and equipment to complete complex intra-thoracic surgery under a chest wall trocar or tiny incision, which has changed the concept of treatment of some cardiac surgical diseases and is the future direction of cardiac surgery development. This kind of TV thoracoscopic surgery is done through two to three “keyholes” with the assistance of TV image surveillance to complete the operation that used to be performed by traditional open-heart surgery. The essence is to operate with a “lumpectomy”, which is equivalent to extending the surgeon’s eyes into the patient’s chest cavity for surgical operation, which has the technical characteristics of less trauma, faster recovery and shorter hospital stay compared to traditional open surgery, and the surgical field of view, lesion appearance, surgical scope and safety are even better than open surgery. The essence is the same as the principle of open surgery, but changes the way of observation during the operation. The advantages of thoracoscopic surgery are very obvious: 1. Small surgical trauma: Ordinary open-chest surgery requires sawing open the sternum, and the general incision reaches more than 20 cm, and it has to be forcibly propped open, which is very traumatic. Post-operative pain has been difficult to solve. Thoracoscopic surgery can be completed by making three small 1.5cm long incisions on the chest wall. The surgery no longer splits the sternum. 2, less surgical bleeding: traditional heart surgery is very traumatic, bleeding, and sometimes the intraoperative hemostasis time is longer than the surgery itself, which is traditionally the major user of blood in the blood bank. The lumpectomy has small trauma, less bleeding, short time to stop bleeding, and some operations even do not need blood transfusion. 3, light postoperative pain: 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, after thoracoscopic surgery patients have light pain, 24 hours to get out of bed, 2-4 weeks after surgery can participate in physical activities. 4, less postoperative complications: conventional open-heart surgery due to the large surgical trauma, postoperative complications, and nearly 5% of patients will occur after surgery, such as poor healing of the wound complications, and then treatment will be very difficult. This is more acceptable for some elderly patients, patients with poor cardiopulmonary function and physical ability or patients who are not suitable for open-heart surgery with large wounds. 5.Small incision scar, beautiful: the traditional surgery which was considered as “disfiguring surgery” in the past will be changed into “cosmetic surgery” of full thoracoscopic heart surgery, and the cost is low, avoiding the huge scars left by the surgery to bring patients, especially young people, after recovery. It will avoid the psychological and social pressures that the huge scars left by the surgery may bring to patients, especially young people, after recovery. The fully thoracoscopic cardiac surgery is performed with only one to three small holes in the chest wall, and for patients with high cosmetic requirements, the surgical incisions are small and aesthetically pleasing. Most are happy to accept it. Total thoracoscopic cardiac surgery technique is a new minimally invasive cardiac surgery method that emerged with the rapid development of videography technology and the continuous innovation of micro-lumpectomy instruments, which has been gradually applied to all kinds of atrial and ventricular septal defects, all kinds of mitral valve and tricuspid valve replacements and plastic surgery, etc. The Department of Thoracic Surgery of Nanjing Chest Hospital has taken the lead in successfully performing various types of atrial septal defect, ventricular septal defect, mitral valve replacement and tricuspid valvuloplasty in Jiangsu Province, and all of them were successfully discharged from the hospital. This is bound to bring a boon to the heart patients in Jiangsu province.