In the past two months, old man Huang had recurrent chest tightness and was found to have a left upper lung nodule on external CT examination. On our spiral thin-layer CT (low dose), a small nodule of 1.0×0.5 cm in the posterior segment of his left upper lung apices was shown, and the imaging features were very consistent with the manifestation of lung cancer. Since the old man had suffered from chronic emphysema for many years, smoked heavily and had poor lung function, he could not tolerate general lobectomy surgery, which caused great trouble to the clinical surgeon. In response to this situation, after intra-departmental discussion, a thoracoscopic resection of the posterior segment of the left upper apical lung and a mediastinal lymph node dissection were successfully performed for the old man. The operation was successful, with the aim of maximizing tumor removal, preserving healthy lung tissue, protecting lung function and improving the patient’s quality of life. After careful post-operative care, Mr. Huang recovered very quickly and was discharged from the hospital five days after surgery. According to Director Chen Gang, the Department of Thoracic Surgery has so far completed more than 20 cases of lung segment surgery for early-stage lung cancer that cannot tolerate lobectomy, with the lesion diameter within 2 cm. Thoracoscopic lung surgery has a clearer field of view, reveals sufficient angles, reduces damage to blood vessels and lung tissue, helps reduce postoperative atrial fibrillation, pulmonary air leak, and lung infection, helps patients actively cough and excrete sputum after surgery, and enables patients to recover earlier after surgery and shorten their hospital stay. However, total lumpectomy lung segment resection is more difficult and the operation requires higher requirements for the operating surgeon. In addition to the need for skilled thoracoscopic operating techniques, it is also important to strictly grasp the indications for lung segment resection.