Thoracoscopic technology has changed the treatment concept of some thoracic diseases In surgical practice, the establishment of treatment plan is often based on two main points: firstly, how necessary the surgery is, and secondly, how well the patient tolerates the surgery. In traditional thoracic surgery, the huge trauma of a standard 20-40 cm long posterior lateral incision or a median open incision is a great test for the patient’s physical condition and psychological tolerance; the gain-loss ratio of the surgery needs to be carefully weighed in particular. The trauma of open-heart surgery has to be taken into account in the surgeon’s decision making. The excruciating pain of open heart surgery is enough to make many patients shy away from it, leaving some “minor” diseases looking for second-best treatments. A typical example is the management of small peri-pulmonary nodules. It has long been documented that more than half of small peri-pulmonary nodules larger than 1 cm without calcification are malignant. However, in the past, still many physicians advised follow-up observation of these patients, and the fear of open-heart surgery led physicians and patients together to make a decision that was neither rational nor scientific. Thoracoscopic surgery completes the excisional biopsy of lung nodules with less trauma, which eliminates the patient’s worry if it is benign; if it is malignant, it realizes early diagnosis and early treatment, which really brings the progress of lung cancer diagnosis and treatment brought by the development of imaging technology into practice. It can be seen that thoracoscopic technology has made the treatment plan for this condition more scientific. Another example is the treatment of traumatic hemothorax, which is traditionally considered as a guideline for open-chest exploration with a chest drainage volume greater than 200 ml/hour for 3 consecutive hours. The development of such strict guidelines undoubtedly takes into account the trauma of open-chest surgery. In fact, many patients with a chest drainage volume of about 100-150 ml/hour not only lose a large amount of blood under long-term observation, but also have many sequelae symptoms due to coagulative hemothorax in the long term. For such patients, early thoracoscopic surgical exploration to stop the bleeding and remove the blood clot is undoubtedly a more ideal choice as it is less traumatic but the patient is able to obtain better treatment results. It can be said that the principle of treatment of many thoracic surgical diseases has returned to science and rationality because of the minimally invasive technique of thoracoscopy, as there is no more worry about the trauma of opening the chest. Once again, thoracoscopic surgery is an “upgraded” version of traditional thoracic surgery. Thoracoscopic surgery is the foundation of future thoracic surgery. Minimally invasive is the main direction of the development of surgery in the past century. In the past decades, thoracic surgery has undergone a developmental process from major trauma to minor trauma and then to minimally traumatic. A remarkable feature during this time is that the surgery has become less and less destructive to the original structure and function of the body. Thoracoscopic technology cleverly “puts” the surgeon’s eye and the surgeon’s hand equipped with delicate instruments into the patient’s chest cavity, thus enabling precise and long-distance operations with minimal trauma. The future of thoracic surgery, whether it be the foreseeable robotic surgery, telesurgery, or other more minimally invasive or even non-invasive thoracic surgery techniques, will undoubtedly not be possible without the aid of this endoscopic technology. The current rapid development of thoracoscopic surgery makes us look forward to its future with boundless hope. We have reason to believe that, with the support of contemporary high technology, the future of thoracoscopic surgical equipment and surgical instruments will continue to see exciting developments, and the “hands” of thoracoscopists will become more and more comfortable. In the future, with the popularity, stability and cost of these technologies, the traditional treatment plan of many thoracic diseases will be constantly changed. “Do I still need to open my chest for xxx thoracic surgery?” Such a question may be asked repeatedly. It can be said that the future of thoracic surgery is the continuous development and evolution of thoracoscopic surgery. Mastering thoracoscopic technology is mastering the future of thoracic surgery. The future of thoracic surgery will definitely make more progress in this “upgraded” version!