The New Era of Uniportal VATS

  • Peter Sze Yuen Yu
  • Calvin S. H. NgEmail author


Since its advent in the early twenty-first century, uniportal VATS has expanded its utility from simple procedures (such as thoracic sympathectomy, pleural deloculations, mediastinal biopsies, pneumothorax, and wedge resections) [1–4] to major lung resections [5, 6]. For over a decade, this technique has become in vogue as surgeons gradually overcome the technical challenges, and perceived its potential benefits for patients in terms of reduced access trauma and postoperative discomfort, reduced chest wall pain and paresthesia, and quicker recovery [7].


  1. 1.
    Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg. 2004;77(2):726–8. Scholar
  2. 2.
    Rocco G, Brunelli A, Jutley R, Salati M, Scognamiglio F, La Manna C, La Rocca A, Martucci N. Uniportal VATS for mediastinal nodal diagnosis and staging. Interact Cardiovasc Thorac Surg. 2006;5(4):430–2. Scholar
  3. 3.
    Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg. 2005;28(1):43–6. Scholar
  4. 4.
    Ng CS, Rocco G, Wong RH, Lau RW, Yu SC, Yim AP. Uniportal and single-incision video-assisted thoracic surgery: the state of the art. Interact Cardiovasc Thorac Surg. 2014;19(4):661–6. Scholar
  5. 5.
    Gonzalez D, Paradela M, Garcia J, Dela Torre M. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg. 2011;12(3):514–5. Scholar
  6. 6.
    Ng CS, Kim HK, Wong RH, Yim AP, Mok TS, Choi YH. Single-port video-assisted thoracoscopic major lung resections: experience with 150 consecutive cases. Thorac Cardiovasc Surg. 2016;64(4):348–53. Scholar
  7. 7.
    Ng CS, Lau KK, Gonzalez-Rivas D, Rocco G. Evolution in surgical approach and techniques for lung cancer. Thorax. 2013;68(7):681. Scholar
  8. 8.
    Bagan P, De Dominicis F, Hernigou J, Dakhil B, Zaimi R, Pricopi C, Le Pimpec Barthes F, Berna P. Complete thoracoscopic lobectomy for cancer: comparative study of three-dimensional high-definition with two-dimensional high-definition video systems dagger. Interact Cardiovasc Thorac Surg. 2015;20(6):820–3. Scholar
  9. 9.
    Ng CS, Wong RH, Lau RW, Yim AP. Minimizing chest wall trauma in single-port video-assisted thoracic surgery. J Thorac Cardiovasc Surg. 2014;147(3):1095–6. Scholar
  10. 10.
    Li Z, Oo M, Nalam V, et al. Design of a novel flexible endoscope-cardioscope. ASME. International design engineering technical conferences and computers and information in engineering conference, Vol. 5B: 39th mechanisms and robotics conference.Google Scholar
  11. 11.
    Li Z, Ng CS. Future of uniportal video-assisted thoracoscopic surgery-emerging technology. Ann Cardiothorac Surg. 2016;5(2):127–32. Scholar
  12. 12.
    Ng CS, Pickens A, Siegel JM, Clymer JW, Cummings JF. A novel narrow profile articulating powered vascular stapler provides superior access and haemostasis equivalent to conventional devicesdagger. Eur J Cardiothorac Surg. 2016;49(Suppl 1):i73–8. Scholar
  13. 13.
    Ng CSH, Capili F, Zhao ZR, Yu PSY, Ho JYK, Lau RWH. Laser resection of pulmonary nodule via uniportal thoracoscopic surgery. J Thorac Dis. 2017;9(3):846–8. Scholar
  14. 14.
    Zhao ZR, Lau RW, Yu PS, Wong RH, Ng CS. Image-guided localization of small lung nodules in video-assisted thoracic surgery. J Thorac Dis. 2016;8(Suppl 9):S731–7. Scholar
  15. 15.
    Ng CS, Man Chu C, Kwok MW, Yim AP, Wong RH. Hybrid DynaCT scan-guided localization single-port lobectomy. [corrected]. Chest. 2015;147(3):e76–8. Scholar
  16. 16.
    Yu PSLR, Capili GF, Wan IYP, Underwood MJ, Chu CM, Yu SCH, Ng CSH. Minimally-invasive sublobar resection of tiny pulmonary nodules with real-time image guidance in the hybrid theatre. Innovations (Phila). 2016;11:S98–9.Google Scholar
  17. 17.
    Ng CS, Yu SC, Lau RW, Yim AP. Hybrid DynaCT-guided electromagnetic navigational bronchoscopic biopsy†. Eur J Cardiothorac Surg. 2016;49(Suppl 1):i87–8.
  18. 18.
    Gonzalez-Rivas D, Fernandez R, de la Torre M, Rodriguez JL, Fontan L, Molina F. Single-port thoracoscopic lobectomy in a nonintubated patient: the least invasive procedure for major lung resection? Interact Cardiovasc Thorac Surg. 2014;19(4):552–5. Scholar
  19. 19.
    Zhao ZR, Lau RW, Ng CS. Non-intubated video-assisted thoracic surgery: the final frontier? Eur J Cardiothorac Surg. 2016;50(5):925–6. Scholar
  20. 20.
    Liu J, Cui F, Pompeo E, Gonzalez-Rivas D, Chen H, Yin W, Shao W, Li S, Pan H, Shen J, Hamblin L, He J. The impact of non-intubated versus intubated anaesthesia on early outcomes of video-assisted thoracoscopic anatomical resection in non-small-cell lung cancer: a propensity score matching analysis. Eur J Cardiothorac Surg. 2016;50(5):920–5. Scholar
  21. 21.
    Liu CC, Wang BY, Shih CS, Liu YH. Subxiphoid single-incision thoracoscopic left upper lobectomy. J Thorac Cardiovasc Surg. 2014;148(6):3250–1. Scholar
  22. 22.
    Suda T, Ashikari S, Tochii S, Sugimura H, Hattori Y. Single-incision subxiphoid approach for bilateral metastasectomy. Ann Thorac Surg. 2014;97(2):718–9. Scholar
  23. 23.
    Kim AW, Kull DR, Zielinski M, Boffa DJ, Detterbeck FC. Transcervical wedge resection after transcervical extended mediastinal lymphadenectomy. Innovations (Phila). 2014;9(4):327–9. Scholar
  24. 24.
    Obiols C, Call S, Rami-Porta R, Trujillo-Reyes JC. Utility of the transcervical approach in bilateral synchronous lung cancer. Asian Cardiovasc Thorac Ann. 2015;23(8):991–4. Scholar
  25. 25.
    Tezel C, Dogruyol T, Baysungur V, Yalcinkaya I. The most minimally invasive lobectomy: videomediastinoscopic lobectomy. Surg Laparosc Endosc Percutan Tech. 2016;26(4):e73–4. Scholar
  26. 26.
    Zhu LH, Chen L, Yang S, Liu D, Zhang J, Cheng X, Chen W. Embryonic NOTES thoracic sympathectomy for palmar hyperhidrosis: results of a novel technique and comparison with the conventional VATS procedure. Surg Endosc. 2013;27(11):4124–9. Scholar
  27. 27.
    Zhu LH, Du Q, Chen L, Yang S, Tu Y, Chen S, Chen W. One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: outcomes and consequences. J Thorac Cardiovasc Surg. 2014;147(1):25–8. Scholar
  28. 28.
    Wu YC, Yen C, Yeh CJ, Hsieh MJ, Chen TP, Chao YK, Wu CY, Yuan HC, Ko PJ, Liu YH, Liu HP. Feasibility of transumbilical surgical lung biopsy and pericardial window creation. Surg Innov. 2014;21(1):15–21. Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Division of Cardiothoracic Surgery, Department of SurgeryPrince of Wales Hospital, The Chinese University of Hong KongHong Kong SARChina

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