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The establishment of minimally invasive surgery is a complex and difficult task. Video-assisted thoracic surgery (VATS) refers to a minimally invasive surgical technique that represents a less invasive approach to thoracic surgery using thoracoscopy. For lung cancer or esophageal cancer surgery, planning and establishing a team for minimally invasive surgery for the first time is not a simple task. Technical advances in surgical devices and the enhanced skill of surgeons are cornerstones of the development of minimally invasive surgery. Here, we review the meaning of minimally invasive thoracic surgery and discuss how to establish a team approach for VATS procedures.