Thoracoscopy is regarded as one of the major breakthroughs in thoracic surgery in the last century and is a representative procedure of minimally invasive thoracic surgery. Video-assisted Thoracoscopic Surgery (VATS) is a new minimally invasive thoracic surgery technique using modern television camera technology and high-tech surgical instruments and equipment to complete complex surgery in the chest wall under a trocar or tiny incision. It is the most significant progress of thoracic surgery at the end of the 20th century and is the direction of the future development of thoracic surgery. The development of TV thoracoscopic surgery has completely changed the bad impression of thoracic surgery with big damage and slow recovery. It is a typical representative of the modern trend of minimally invasive technology. With the accumulation of experience and the progress of technology, the scope of adaptation of TV thoracoscopic surgery is becoming broader and broader at present. 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. to avoid or cope with some unexpected injuries. Since this medical technology has so many advantages, what diseases are suitable for thoracoscopic surgery? Simply put, the indications for televised 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 15 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. It is now 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 rate is better than that of open-heart surgery. Total thoracoscopic lobectomy with systemic lymph node dissection is the preferred surgical approach for early-stage lung cancer as recommended by NCCN guidelines. For elderly patients with poor lung function, total lumpectomy with anatomical lung segment resection can also be considered when the condition permits, which has the advantages of less trauma to the patient, less loss of lung function and faster postoperative recovery. In recent years, there is a tendency to widen the surgical indications to relatively advanced lung cancer, which is completely feasible in some cases from the technical point of view, but the long-term survival effect needs further verification. 3.For resection or exploration of benign lung diseases, try to choose thoracoscopic surgery. 4.Benign esophageal lesions, cardia loss retardation or relatively early esophageal cancer are all indications for TV thoracoscopic surgery. 5.Pleural lesions, hand sweats, 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, which will help to jointly select the appropriate surgical modality.