Tracheal sleeve pneumonectomy for lung cancer still remains a difficult operation with high complication rates. This video presents the technique of 43 tracheal sleeve pneumonectomies (TSP) performed from 1983 to 1995 with no anastomotic complications (stenosis or fistula). This video shows the indications and technical details of the new ventilation tube and of tracheo-bronchial suturing personally devised.