The curative effect of lung cancer depends on the period of detection. At present, many early cases encountered in the clinic are found by physical examination or inadvertently discovered when visiting the doctor for other diseases, with small masses on the lungs by X-ray chest film or CT examination, and usually asymptomatic. For them it is fortunate that they can get the opportunity of early surgery. However, not all lung masses are cancer, but may also be inflammation, tuberculosis and other diseases. It is difficult to diagnose such a small lung mass like a soybean, and it is impossible to biopsy such a small mass to confirm the diagnosis, and it is also unacceptable to open a major operation on the chest for such a small mass. In the past, regular review and experimental drug treatment were adopted, but it took a few months or a few years, and the best time for treatment was missed for those who were diagnosed with cancer. For microscopic lung masses, thoracoscopic minimally invasive treatment has obvious advantages, with simultaneous diagnosis and treatment. In cooperation with radiology, preoperative puncture localization is performed to facilitate accurate and rapid intraoperative confirmation of the lesion. Intraoperative wedge resection and rapid pathological characterization ends the operation if benign, and continues with full thoracoscopic lobectomy and lymph node dissection if malignant. It solves the problem of diagnosing and treating microscopic lesions in the lung. Thoracoscopic technology has provided new means for thoracic surgeons and moreover brought new hope to patients. In a classic case, a patient surnamed Wang was diagnosed with cancer by puncture of a 4 cm diameter mass in the right upper lung, while a 0.6 cm diameter mass in the left lower lung could not be diagnosed, and the important thing is that if the mass in the left lower lung is caused by metastasis of the right upper lung cancer, it is a very advanced stage, and the treatment and prognosis are very different from those of benign mass in the left lower lung. The surgery was preceded by thoracoscopic left lower lung wedge resection and rapid pathology: the left lower lung mass was benign, i.e. the mass was not related to right upper lung cancer, and thoracoscopic radical right upper lung cancer surgery was performed immediately, which perfectly solved the diagnosis and treatment problem. Another patient with the surname of Zhang had a 0.8 cm diameter mass in the right upper lung with the CT sign of “ground glass lesion”, which had been observed in the outpatient clinic for several years without any change in size and could not be diagnosed. Because of the lesion in the lung, the patient had a long-term mental burden, which caused severe depression and prevented her from working and living normally. He underwent thoracoscopic surgery and had a wedge-shaped resection of the right upper lung first, and the intraoperative rapid pathology was “fine bronchoalveolar cell carcinoma”.