OBJECTIVES: Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic
surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main
procedural steps, optimize its indications and perioperative management and identify elements to assist in future training.
METHODS: The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest
Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied
to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds.
RESULTS: Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was
not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be <4 cm. Agreement was reached on
many points outlining the currently accepted definition of a UniVATS lobectomy, its indications and contraindications, perioperative clinical
management and recommendations for training and future research directions.
CONCLUSIONS: The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer
follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for
major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is
the establishment of a UniVATS section inside the ESTS databases.
Keywords: Uniportal video-assisted thoracoscopic surgery • Single site incision • Lung cancer • Consensus • Delphi approach
- Uniportal video-assisted thoracoscopic surgery