Abstract Internet teleconferences using an advanced academic network are now quite common in the medical field. However, such conferences are still not particularly common in the area of pulmonary surgery. Here, we report the practical lessons learned from participating in international teleconferences on video-assisted thoracic surgery. Between November 2007 and February 2010, teleconferences with high-definition live video feeds were held five times between Fukuoka University Hospital and other institutions across the Asia-Pacific region. For these teleconferences, a digital video transport system, connected with the high-performance network of the Asia-Pacific Advanced Network, was used to establish communication. In all conferences, discussions were conducted without difficulty. No surgeries were performed live; a video presentation of the recorded surgery was sufficient. Though technical assistance is required to connect and communicate with other professionals, international teleconferences are a worthwhile and intellectually stimulating activity.