Full thoracoscopic resection of tracheal cancer, which is more difficult than “engraving on egg”, is the first case in China. Mr. Chen of Ninghai, who has been smoking for 40 years, was unfortunately affected by the malignant tumor in the lower trachea. What’s worse, Mr. Chen’s physical condition is very poor due to years of smoking, and he can’t stand the traditional open surgery. Waiting for death or finding another way out? The 68-year-old Chen, a Ninghai native, has been smoking since he was 28 years old and smokes a pack every day. In the second half of last year, Chen began to cough incessantly, and often felt shortness of breath, and in severe cases, even gasping for breath. At the beginning of this year, Chen could see blood in the sputum he spat out. When he went to the hospital, he was shocked: the doctor diagnosed that it was likely to be tracheal tumor and squamous cancer. In March this year, Chen was transferred to the second hospital for treatment. The second hospital’s multidisciplinary consultation concluded that only surgical removal of tracheal tumors would give Lao Chen a chance of long-term survival. However, Lao Chen’s tracheal tumor, the location of the disease is “very bad” – located in the lower part of the trachea. Zhao Guofang introduced to the reporter that the location of lower trachea is very special, surrounded by veins, esophagus, laryngeal nerve and other important tissues, which makes the surgery very difficult. Generally speaking, the tumor of lower trachea needs to be removed by opening an incision of about 30 cm in the right side of the chest, then cutting off all the muscles of the operation site and propping up the ribs before the operation. Unfortunately, Chen’s years of smoking had made his health very poor, and he suffered from severe anemia and loss of left kidney function. It was impossible for his body to support him to “open a big knife”. The doctors estimated that without surgery, Chen’s life expectancy would be about a year. The challenge of “the most complicated surgery” is to find a different way to do it, but can we try a small operation? Zhao Guofang and his team came up with a bold treatment plan: why not use minimally invasive full thoracoscopic surgery. Only a few small holes are needed in the chest wall, and the surgery is performed through a thoracoscope, with small incisions and low complications. Although the advantages of fully thoracoscopic surgery are obvious, it places higher demands on the surgical plan, surgical skills, and precision of operation. Tracheal surgery has long been considered one of the most complex surgical procedures in the field of surgery. The accuracy and safety of the surgery cannot be 100% guaranteed by traditional surgery, let alone the “full thoracoscopic surgery” which requires higher surgical skills. Eventually, Chen decided to give it a go on the advice of his doctor. Not long ago, Chen was pushed onto the operating table. The surgery was successful, with the 3 cm long tumor’s trachea removed and less than 100 ml of bleeding. 12 days later, Chen recovered and was discharged from the hospital, where he is doing well. Dr. Zhao Guofang described the whole operation as “like carving words into an egg”. To perform tracheal surgery completely thoracoscopically, the doctor could only look at a two-dimensional TV screen and use various instruments to complete a series of complex operations through several small holes. And each step of the operation requires skillful and precise, in the narrow surgical space of the slightest inadvertence, it may hurt other important organs. The reporter learned that this precise surgery done by Dr. Zhao and his team is the first of its kind in China.