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The surgical management of patients with non-small cell lung cancer will remain central to the therapeutic armamentarium in 2023. Around 30 percent of lung cancer patients will undergo surgery. The advent of targeted therapies and immunotherapy has revolutionized the management of patients with advanced lung cancer. Surgery must also continue to innovate and apply the concepts of predictive, personalized, participatory, and preventive medicine (MP4), enabling us to define, by 2023, precision surgery. The objectives are manifold: to reduce post-operative complications and thus have a direct impact on post-operative morbidity and mortality; and to improve overall survival, recurrence-free survival, and patients’ quality of life. This is made possible as much by the availability of new technical tools with the arrival of minimally invasive and robotic surgery, as by the improvement of patient care pathways with, in particular, the development of enhanced recovery after surgery (ERAS) programs. A better understanding of the mechanisms involved in tumor progression, as well as tumor–host interactions, is also essential, making it possible to identify new prognostic factors. Moreover, beyond the tumor stage, various studies have demonstrated that undernutrition, sarcopenia, and the patient’s inflammatory state have a direct impact on post-operative outcomes. A broader vision, centered around the patient, seems to be the key to the innovation of lung cancer surgery in 2023.