[Risk and its management in video-assisted thoracic surgery]

To avoid intraoperative accidents or trouble with patients in video-assisted thoracic surgery (VATS), the surgeons should complete sufficient training. Patients tend to have excessive expectation for less invasive approach, proper information of VATS procedure must be given to the patients as well as the referring physicians. Sufficient cancer surgery should be considered prior to applying VATS approach. If cancer recurred after VATS operation, it is far from minimally invasive surgery. The lung and the pulmonary artery are very fragile. Surgeons who are performing VATS surgery must have a skill of suturing the lung and some bleeding control technique. These well trained technique and the ability of judge will manage the risk and the accident in VATS operations.