Recently, a single-port thoracoscopic total left lung resection with hilar mediastinal lymph node dissection was performed, and the patient recovered well and was discharged smoothly after the operation, which is the first case in Henan Province and fills the corresponding medical gap. The patient was a male, 50 years old, admitted with “cough and sputum for more than 40 days”. Electronic bronchoscopy showed that the lesion in the lower lobe of the left lung was squamous carcinoma on biopsy, and CT showed multiple hilar lymph nodes enlargement on the left side. Prof. Shuanglin Zhang led a team of experts in thoracic and cardiovascular surgery to discuss with the operating room and anesthesiology department, and then decided to perform a single-operating hole total thoracoscopic left-sided total pneumonectomy for the patient. After successful double-lumen tracheal intubation, the patient was placed in the right lateral position, and a 100px incision was opened along the 5th intercostal space in the left thorax, and a skilled thoracoscopic technique was used to free the hilar arteries and bronchi in turn, and the lung lobes were closed and severed one by one with a lumpectomy linear cutter, and then the upper and lower lobes were cut and separated in the thoracic cavity before the lobes were removed in turn through the narrow incision. Systematic hilar and mediastinal lymph node dissection was then performed, and the entire procedure was performed in about 60 minutes. The single-hole operation has many advantages over conventional thoracoscopic surgery: the operating hole is 3-5 cm, there is no obvious scar on the body surface after suturing, the postoperative pain is significantly reduced, the amount of analgesic drugs is reduced, and the recovery time is faster and the hospital stay is shorter. The difficulty of single-hole operation lies in the inability to form a triangle in the thoracic cavity as in ordinary thoracoscopic surgery, the underdeveloped lung fissure, the often occurring variant vessels of the pulmonary artery and pulmonary vein, and the branching direction of the bronchus and many other factors, which also cause many difficulties in the operation, and performing total pneumonectomy under a single operation hole increases the corresponding difficulty. After years of exploration and practice, the team of thoracic and cardiovascular surgery at the First Affiliated Hospital of Henan University has been overcoming the difficulties of thoracoscopic technology, and the single-hole thoracoscopic technology has been gradually perfected. The successful implementation of single-hole total thoracoscopic total pneumonectomy is another leap forward, which will benefit patients more.