The Thoracic Surgery Department of the First Affiliated Hospital of Zhengzhou University completed the first thoracoscopic mediastinal tumor resection and left upper lung wedge resection for children in Henan Province Patient’s basic information: male, 6 years old, admitted with chest tightness and chest pain for 1 month, CT suggested left anterior upper mediastinal occupancy, teratoma was considered. Li Xiangnan, Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University Surgical method: joint anesthesia, sedation of the child, no intubation, no administration of inotropic drugs, preservation of spontaneous respiration, mask oxygen administration, intraoperative vagal nerve block to prevent choking, thoracoscopic resection of the tumor, and wedge resection of the left upper lung because the tumor partially invaded the left upper lung. The operation time was one hour, and the operation went smoothly! Surgical significance: traditional thoracoscopy is not suitable for children’s surgery because 1. children have narrow airways and cannot be ventilated with one lung because of the inability of double lumen intubation, so lumpectomy cannot be completed! Children’s lung function is not well developed and they cannot be ventilated with one lung from the physiological function point of view, so thoracoscopy has always been a no-go area for pediatric patients! The realization of preserving autonomous respiration and non-intubation surgery has completely overturned the traditional concept and is a blessing for pediatric patients!