A 56-year-old male patient was admitted due to one small pulmonary nodule in the posterior segment of left upper lobe. Preoperative examinations showed no distant metastasis, pulmonary ventilation function and small airway function were highly damaged and could not tolerate lobectomy. Chest computed tomography (CT) showed one small pulmonary nodules on the posterior segment of left lung, which was considered to be early malignant lesions. In addition, no remarkably swollen lymph node was visible in the mediastinum. Therefore, video-assisted thoracic surgery (VATS) left upper lobe posterior segmentectomy was performed, and intraoperative frozen section confirmed the diagnosis of adenomatous hyperplasia of alveolar epithelial. Sequential dissection (or, single-direction approach) was applied in this surgery to avoid frequent turn-over of the lung lobes and shift of visual angle during the procedures. The Electric hook used in this surgery enables careful dissection and dissociation, with clear visual field and small blood loss.