Our department recently treated 12 consecutive patients with small pulmonary nodules with postoperative pathology all diagnosed as lung cancer, including 3 cases followed up in outside hospitals. The patients came to our hospital with great mental and psychological pressure and firmly requested surgical treatment, and we used preoperative guided metal hook puncture localization technique to remove the pulmonary nodules, and postoperative pathology all confirmed lung cancer (shown below). With the development of CT technology, more and more small pulmonary nodules are being detected, which makes the diagnosis more difficult for clinical, imaging and pathologists, and also brings some trouble to whether patients receive treatment or not. The literature reports that about more than half of small pulmonary nodules are malignant. For those small pulmonary nodules that are especially deep from the pleura, less than 1 cm and some not very dense, it is very necessary to obtain pathological diagnosis with accurate localization and timely and correct treatment. For the diagnosis of small pulmonary nodules, televised thoracoscopic pulmonary wedge resection is a minimally invasive, rapid, safe, and effective diagnostic method. However, an important factor determining the success of the procedure is the ability to locate the lesion quickly and accurately. In the absence of preoperative localization measures, some cases have been forced to intermediate open-heart surgery because the lesion could not be found; worse still, even through open-heart surgery, the lesion could not be found. Over the years, our department has accumulated rich experience in preoperative localization of small pulmonary nodules in close cooperation with the radiology department, and usually applies preoperative CT-guided metal hook puncture localization, Melanoplasty localization and Melanoplasty combined with gelatin particles to localize small pulmonary nodules, and the localization method is chosen flexibly according to the location, size and degree of small nodules and the estimated waiting time for surgery after localization. The entire procedure takes only 10-20 minutes, and the patient does not experience any significant pain. After the puncture is completed, the patient is sent directly to the operating room to undergo thoracoscopic minimally invasive lung wedge resection, and the specimen is immediately sent to pathology for examination. Patients can generally get out of bed on the second day after surgery, have their chest tubes removed on the third or fourth day, and be discharged from the hospital in 5-7 days. Therefore, small lung nodules found during physical examination should not be taken lightly, and it is best to have an experienced thoracic surgeon and imaging doctor work together to formulate a treatment plan for them, so as to minimize the great mental and psychological stress caused by follow-up visits and even delayed treatment. If early-stage lung cancer is diagnosed and treated with minimally invasive lung cancer surgery in time, the 5-year survival rate can reach over 90% without any treatment after surgery. Therefore, the significance of early and late detection is completely different for lung cancer patients.