Thanks to the recent improvements in thoracoscopy, a great deal of complex lung resections can be performed without performing thoracotomies. During the last years, experience gained through video-assisted thoracoscopic techniques, enhancement of the surgical instruments and improvement of high definition cameras have been the greatest advances. The huge number of surgical videos posting on specialized websites, live surgery events and experimental courses has contributed to the rapid learning of minimally invasive surgery during the last years. Nowadays, complex resections, such as post chemo-radiotherapy resections, lobectomies with chest wall resection, bronchial and vascular sleeves are being performed by thoracoscopic approach in experienced centers. Additionally, surgery has evolved regarding the thoracoscopic surgical approach, allowing us to perform these difficult procedures by means of a small single incision, with excellent postoperative results.