The choice of minimally invasive thoracoscopic surgery for the treatment of lung disease is a difficult one for the patient’s family. Families have internal expectations for their patients’ loved ones and want the best treatment with the least trauma and the most benefit. Whenever a surgeon recommends a surgical approach, the patient’s family is inevitably curious, confused, and puzzled about the other approach, which brings about a dilemma. Here are a few suggestions for the patient’s family to carefully experience, not to completely solve the confusion, but only to help. 1, the surgical treatment of pneumothorax pulmonary alveoli, not the best minimally invasive thoracoscopic surgery, need to be based on the number of large pulmonary alveoli, the severity of thoracic emphysema, the severity of thoracic adhesions, if young patients with pneumothorax, the number of large pulmonary alveoli is small, or although huge, but the target area is obvious, thoracoscopy often benefits, and severe emphysema, the target area is not obvious in elderly patients, sometimes open-heart surgery is better. Because certain weak areas of emphysema are not effective to cut out and only need to be treated with sutures, open chest can be better treated and inexpensive. 2. Treatment of early stage lung cancer. For patients with early stage, smaller masses and less obvious lymph node enlargement, thoracoscopic surgery can manifest the advantages of minimally invasive surgery, which does not involve the rib cage, fast recovery, and is in line with the principles of tumor treatment, completely clearing the lymph nodes, achieving the same effect as open chest lung cancer surgery and having the advantage of minimally invasive surgery, but of course, the cost is slightly higher. 3. In mid-stage lung cancer, the mass is larger, the lymph nodes are obviously enlarged, or the blood vessels are invaded, which may require angioplasty or bronchoplasty. In such patients, open-chest surgery is safer, in line with the principles of tumor treatment, to achieve complete lymph node clearance, and the operation time is not long. The benefits of open-chest surgery exceed the minimally invasive advantages brought by minimally invasive thoracoscopy, which is more cost-effective. 4. The high skill of thoracoscopic surgery is not a reason for all diseases to become indications for thoracoscopic surgery. Although thoracoscopic angioplasty, bronchoplasty, and total lung resection can be done thoracoscopically, and the number of cases is small at present, it is not so difficult in my opinion, however, superior surgical skills are not an excuse for thoracoscopic surgery, the purpose of surgery is to make patients benefit, not simply to do surgery for the sake of doing thoracoscopic surgery. 5. For patients who are difficult to choose, trying thoracoscopic surgery and finding that it is against the principle of tumor treatment should be done in time with open-heart surgery instead of insisting to continue thoracoscopic doing. The prolongation of operation time and the breakage of lymph nodes will increase the recurrence of patients and the occurrence of complications. 6, in today’s tense doctor-patient relationship, I hope more sincerity, more understanding, only in this way, the doctor can be respected, the patient can get better treatment, to achieve a win-win situation. 7. After the thoracic surgery department of Shanghai Pulmonary Hospital was awarded the title of national key specialty and the annual volume of surgery reached 3350 cases, what brought you doctors is no longer the consideration of surgical skills, but the commitment of how to better benefit the patients!