Whenever we think of thoracic surgery, we conjure an image of a large cut on chest wall, cutting of muscles, spreading of ribs and entering the chest to perform lung and mediastinal surgery. As surgeons we were trained through an era of thoracotomy and sternotomy. However, I was fortunate enough to be associated with starting a program of video assisted thoracoscopic surgery (VATS) [1] (Fig. 3.1) at Southampton General Hospital, England. This involved three small cuts on the chest wall, splitting of muscles and entering the thoracic cavity with no injury to the ribs. This became a highly successful program.