Video assisted thoracic surgery(VATS) was rapidly developed in recent years.It's been widely accepted because it was minimally invasive and the patients were fast recovery with a survival rate similar to routine thoracotomy patients.However,more and more attention was paid to the side effect of general anesthesia with double cavity intubation during the surgery.Nonintubated thoracoscopic surgery for lung cancer was progressively developed.This surgery method decreases the side effect compared to general anesthesia with double cavity intubation.However,more surgical difficulty,additional surgical risk and prolonged surgery time were all inevitable become disadvantages of this new method.The less side effect of general anesthesia for patients and the more challenge for thoracic surgeon was brought simultaneous by this new method.More clinic trial should be implemented in validating the advantages and disadvantages.