VATS lung and pleural biopsy for metastatic cancer of unknown primary origin, in case of suspected lung and pleural pathology, is a minimally invasive procedure involving punctures in the chest wall to obtain tissue samples, helping to differentiate malignancies without an identified primary tumor or examine lung abnormalities. The procedure is recommended when lung changes or pleural thickening are visualized, and standard examinations cannot distinguish metastases from tuberculosis, sarcoidosis, or other conditions. Under video guidance, several tissue samples are extracted. The result is a precise diagnosis that determines further treatment strategy.