Television thoracoscopic surgery (VATS) is a prominent representative of minimally invasive surgery in the field of thoracic surgery, which is widely welcomed for its characteristics of less trauma, less pain, faster recovery and compliance, and additionally adds an alternative surgical method for elderly and frail patients with cardiopulmonary insufficiency. VATS is an emerging thoracic surgical technique that has flourished since the 1990s and is being widely used in clinical practice as a minimally invasive procedure. Its indications are: 1. pleural diseases, such as pleural effusion, pleural nodular lesions, abscess chest; 2. pulmonary diseases, such as pulmonary herpes, spontaneous pneumothorax, diffuse lung disorders, benign lung tumors, pulmonary arteriovenous fistula, pulmonary cyst, bronchiectasis, early primary lung cancer, severe emphysema; 3. Esophageal lesions, such as esophageal smooth muscle tumor, cardia loss, esophageal diverticulum, esophageal cancer; 4, mediastinal tumors, such as thymoma, teratoma, mediastinal cyst; 5, chest trauma, such as traumatic hemothorax, thoracic foreign body, diaphragm rupture; 6, cardiovascular disease, such as PDA, pericardial effusion, CABG, etc. Spontaneous pneumothorax due to ruptured pulmonary blisters is the best indication for VATS, especially for recurrent pneumothorax; bilateral spontaneous pneumothorax (whether or not it occurs at the same time); spontaneous pneumothorax with poor outcome after more than 1 week of conservative treatment; special personnel such as pilots, divers, those who are away from medical units for a long time; and COPD patients with pulmonary insufficiency who cannot tolerate open-heart surgery are all indications for surgery. In addition, surgery should be performed on patients with large pulmonary blisters that compress the lung tissue and do not rupture but seriously affect the patient’s respiratory function. The above methods are mostly suitable for small pulmonary blisters, but for larger pulmonary blisters, Endo GIA is used to remove the blister from the base of the blister, which is more accurate and reliable, but for multiple clusters or huge pulmonary blisters, we suggest using an enlarged incision of 3-5 cm, oval clamp and retracting the blister. Of course, the Endo GIA resection method can be tried in patients with good family economy. For diffuse pulmonary herpes, without the possibility of lung transplantation, it is appropriate to use talcum powder evenly sprayed and perform pleural fixation, while others use tincture of iodine gauze wall pleural friction fixation. For unexplained pleural nodules with pleural effusion, repeated thoracic aspiration to send cytology examination can not confirm the diagnosis, the best way is to perform multi-point pleural biopsy under thoracoscopy, and immediately send “frozen section” examination, such as clear for malignant lesions, then to talcum powder evenly sprayed pleural fixation, so that both clear diagnosis, and can This can not only clarify the diagnosis, but also eliminate the effusion, improve the symptoms, prevent recurrence and improve the quality of life. One patient in this group came for treatment with recurrent chest pain and inability to sleep for three months, and was discharged with chest pain and pleural fluid disappeared and good sleep at night after this operation. Most isolated peripheral pulmonary nodules are difficult to diagnose, because they are inaccessible by fiberoptic bronchoscopy and difficult to locate by percutaneous pulmonary puncture. Thoracoscopy can successfully remove the nodule and at the same time clarify the diagnosis. In contrast, VATS lung biopsy is favored by patients because it is less invasive and has less impact on cardiopulmonary function. While traditional surgical methods for patients with thoracic trauma usually have large incisions and add a second trauma to the patient, VATS can solve problems such as hemothorax, foreign bodies in the chest cavity and rib fracture repositioning and fixation with minimal cost and good results. Of course, as an emerging surgical technique, it has its limitations. It is not suitable for patients with poor pulmonary function (FEV1 less than 20% of the expected value), abnormal clotting time, myocardial infarction, large tumors, extensive dense adhesions in the pleural cavity, and unstable blood pressure in severe thoracic trauma.