With the development and popularity of TV thoracoscopic surgery, full thoracoscopic surgery has become the preferred treatment option for the diagnosis and treatment of benign mediastinal tumors. Before surgery, CT examination of the chest is routinely performed to clarify the location of tumor (anterior mediastinum, middle mediastinum and posterior mediastinum); to clarify the clear boundary of tumor, intact envelope and no invasion performance. MRI was routinely performed for posterior mediastinum tumor to exclude “dumbbell type” tumor. The surgery was performed by double-lumen tracheal intubation, and the position was either in the healthy side or 45° of the affected side according to the tumor site. The length of the main operation hole is about 1.5~4 cm. Firstly, 30° lumpectomy is inserted from the observation hole to explore the tumor site and whether the envelope is intact, and after it is clear that the surrounding nerves, blood vessels and adjacent organs are not invaded, electric hook or ultrasonic knife is inserted from the operation hole, suction device or oval clamp is inserted, the mediastinal pleura is cut on the surface of the tumor, and the tumor is peeled off by blunt and sharp combination outside the envelope, and when large trophoblastic vessels are encountered, the ultrasonic knife is applied to slow-file coagulation or the Hemolock clamp is applied. In case of large trophoblastic vessels, the tumor should be treated with ultrasonic knife slow-file coagulation or application of Hemolock clips; in case of cystic tumor, unless it is huge and affects the visual field, puncture and extract part of the cystic fluid and try to keep certain tension in order to reveal the boundaries and facilitate separation; if the cystic wall is seriously adhered to the surrounding organs, only lateral cyst excision + mucosal cautery should be performed. Enlarged total thymectomy is performed for thymoma. The incision layout is as described above, and the operating planes are as follows: upper border: upper border of the left innominate vein; lower border: cardiodiaphragmatic angle; anterior border: posterior sternum; posterior border: pericardium and anterior border of the left innominate vein; left and right border: left and right phrenic nerves. The order of freeing: right lower pole – right upper pole – left upper pole – left lower pole, blunt sharp combination of freeing and complete removal of thymus and anterior mediastinal fat, the thymic vein is separated by ultrasonic knife after applying Hemolock clamping, the reference for identifying and protecting the left phrenic nerve is the left intrathoracic vessels. Most mediastinal tumors are benign. Common mediastinal tumors include thymoma, teratoma, neurogenic tumors, and various types of cysts. Regardless of benign or malignant primary mediastinal tumors, as long as there is no clear distant metastasis and respiratory and circulatory system insufficiency, those who are allowed to have chest exploration should be operated early to remove the tumor, because benign tumors may also become malignant. If benign thymoma is not combined with myasthenia gravis (MG), in principle, thymectomy alone can be performed. Some scholars reported that 3-9% of thymomas developed MG after thymectomy and were not combined with tumor recurrence. The interval between thymectomy and the first attack of MG ranged from 2 months to 22 years, and most tumors had an intact envelope. Non-invasive thymomas, although small, do have a tendency to recur locally, and the Kornstein collection indicates that 0% to 12% of non-invasive thymomas recur after surgery. Some authors recommend resection of the tumor with total removal of mediastinal fat to remove the entire tumor. The author believes that T2b (expanded thoracoscopic resection) may be an option for the surgical treatment of non-invasive thymoma according to the MGFA classification of thymectomy procedures. In conclusion, total thoracoscopic resection of benign mediastinal tumors has the advantages of less surgical trauma, faster recovery and fewer comorbidities. With rich experience in thoracoscopic surgery, minimally invasive surgery with total thoracoscopy will become the preferred treatment option for benign mediastinal tumors.