What kind of lung surgery is suitable for the application of minimally invasive means?

  Conventional lung surgery requires a 20CM chest wall incision, which is highly invasive and painful after surgery, often lasting six months to two years. Minimally invasive surgery includes muscle-preserving open-heart surgery and thoracoscopic surgery. Thoracoscopic surgery includes both thoracoscopic-assisted small incisions and pure thoracoscopic surgery. In particular, pure thoracoscopic surgery is the least invasive and has the least postoperative pain.  Thoracoscopic surgery began in the early 1990s and was first applied to simple surgeries such as biopsy of pleural diseases, surgical treatment of spontaneous pneumothorax and biopsy of unexplained lung lesions. Through the efforts of the past 20 years, more complicated surgeries such as lobectomy can also be done thoracoscopically. Thoracoscopic surgery in China has developed almost simultaneously with the rest of the world, and I was fortunate to be one of the first thoracic surgeons to perform thoracoscopic surgery in China.  We currently perform thoracoscopic surgery including pneumothoracic surgery, benign tumors of the pleura or lung, bronchiectasis, chronic lung abscess, etc. We also perform radical lung cancer surgery and lymph node dissection for some peripheral type early lung cancer with tumors less than 5CM. (Our pure thoracoscopic surgery uses two 1CM incisions and one 3-5CM auxiliary incision depending on the size of the lesion, and the surgery is performed completely under a TV monitor without the use of rib spacers that may cause intercostal nerve damage.  Thoracoscopic surgery is less traumatic, less bleeding, faster postoperative recovery and less postoperative pain. It is covered by medical insurance in Shanghai Pulmonary Hospital. However, the technical requirements are high, not every patient is suitable and not every thoracic surgeon can complete it successfully.  With the popularization and progress of the technology, it is believed that one day maybe 50% or even 70% or more of the surgeries will be done under thoracoscopy, thus benefiting the majority of patients.