Television thoracoscopic technology is the most significant technological advancement in thoracic surgery in the last 20 years. The development of TV thoracoscopic surgery has completely changed the undesirable impression of thoracic surgery with great damage and slow recovery. It is a typical representative of the modern trend of minimally invasive technology. With the accumulation of experience and technological progress, the scope of adaptation of TV thoracoscopic surgery is now becoming broader and broader. The surgeon who performs TV thoracoscopic surgery needs two basic conditions: one is to have good training and surgical experience in open-heart surgery, and the other is to have good judgment and reaction ability, as well as more excellent basic anatomical knowledge. in order to avoid or cope with some unexpected injuries. In brief, the indications for TV thoracoscopic surgery cover most of the thoracic surgeries. It is closely related to the nature, location and size of the disease, and even more closely related to the experience of the surgeon, and cannot be generalized. Specifically: 1. mediastinal tumors and cysts: mediastinal tumors below 3~5 cm are generally considered suitable for thoracoscopic surgery. Cysts are not limited by size. The authors once removed a huge cyst of more than 20 cm thoracoscopically. Of course, the location and nature of the tumor and the patient’s medical history should also be taken into consideration. 2.Surgical treatment of lung cancer: At present, lung cancer has become the number one killer in cities. Since the early 1990s, foreign countries started to report the TV thoracoscopic surgery for early stage lung cancer. It has been carried out more in China in the past decade. At present, it is the consensus and common practice of domestic and foreign thoracoscopic experts to give priority to thoracoscopic surgery for early-stage lung cancer, and the long-term survival is at least no worse than that of open-heart surgery. In recent years, there is a tendency to broaden the surgical indications for relatively advanced lung cancer, which is technically feasible in some cases, but the long-term survival effect needs further verification. 3.Benign lung disease resection or exploration: try to choose thoracoscopic surgery. 4.Benign esophageal lesions: or relatively early esophageal cancer are indications for TV thoracoscopic surgery. 5.Pleural lesions and other thoracic surgical diseases. The above indications are all relative. It is necessary to take into account the patient’s condition, economic conditions, requirements for surgery and the experience of the surgeon to choose the most suitable surgery for each patient. The surgeon should inform the patient of the current treatment options to help jointly select the appropriate surgical procedure.