In 1991, Nathanson and Landreneau et al. reported thoracoscopic surgery (VATS), respectively. Since then, the reports of clinical application of thoracoscopy have increased dramatically, and now it has become a mature minimally invasive thoracic surgical technique, which is an important tool for lung cancer treatment. Now we would like to popularize the related knowledge to you. What kind of patients are suitable for thoracoscopic surgery? In general, peripheral lung cancer does not involve the chest wall and mediastinum; enlarged lymph nodes in the mediastinum are not a contraindication to surgery. What kind of patients are not suitable for thoracoscopic surgery? Central lung cancer and mediastinal lymph node metastasis; significant enlargement of hilar or mediastinal lymph nodes; inability to tolerate one-lung ventilation; large tumors (>9 cm in diameter). What are the benefits of thoracoscopic treatment for lung cancer? Compared with open-chest surgery, thoracoscopy is less traumatic and significantly reduces postoperative pain; shortens chest tube placement time and hospitalization time; thoracoscopy preserves the integrity of the thorax and the patient’s whistling function to a large extent compared with conventional open-chest surgery because the chest wall muscles are not cut off and the ribs are not propped open. Can thoracoscopic treatment of lung cancer be complete? Lobectomy with hilar mediastinal lymph node dissection is the standard procedure for non-small cell lung cancer, and there have been questions about its ability to fully dissect lymph nodes. In fact, thoracoscopy can provide a better view than traditional open-heart surgery, with clear exposure of the mediastinum, and can be very competent for systematic mediastinal lymph node dissection. What are the disadvantages of thoracoscopic treatment of lung cancer? There are certain safety risks in thoracoscopic surgery, and the risk of intraoperative hemorrhage is higher. TV thoracoscopy often lacks timely and effective hemostasis methods, and most of them need to be transferred to open surgery in time, but it does not increase the mortality rate due to hemorrhage. The cost of TV thoracoscopic surgery is higher because of the advanced technology and the need for special disposable instruments, all of which are more expensive.