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.

Department of Cardio Thoracic Santa Maria University Hospital Lisbon Portugal

Department of Cardiothoracic Surgery Makassed Charitable Society Hospital East Jerusalem Israel

Department of Cardiothoracic Surgery Shaare Zedek Medical Center Jerusalem Israel

Department of General Thoracic Surgery Fondazione Policlinico Universitario A Gemelli Rome Italy

Department of Surgery Competence Center of Thoracic Surgery Charité Universitätsmedizin Berlin Berlin Germany

Department of Surgery Fairfax Medical Campus Falls Church VA USA

Department of Surgery Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China

Department of Surgery The Chinese University of Hong Kong Hong Kong China

Department of Surgery Thoracic Service Memorial Sloan Kettering Cancer Center New York NY USA

Department of Surgery University of Szeged Szeged Hungary

Department of Thoracic Surgery Cerrahpasa Medical School Istanbul University Cerrahpasa Istanbul Turkey

Department of Thoracic Surgery Evangelisches Krankenhaus Herne Herne Germany

Department of Thoracic Surgery General University Hospital Alicante Spain

Department of Thoracic Surgery Hospital Federal do Andaraí Rio de Janeiro Brazil

Department of Thoracic Surgery Institut Universitaire de Cardiologie et de Pneumologie de Québec Quebec Canada

Department of Thoracic Surgery Maggiore Teaching Hospital Bologna Italy

Department of Thoracic Surgery Malteser Hospital Bonn Germany

Department of Thoracic Surgery Marmara University Hospital Istanbul Turkey

Department of Thoracic Surgery Medical University of Lublin Lublin Poland

Department of Thoracic Surgery National Cancer Institute Milan Italy

Department of Thoracic Surgery Pulmonary Hospital Zakopane Poland

Department of Thoracic Surgery Regional Clinic Hospital Tyumen Russia

Department of Thoracic Surgery San Gerardo Hospital Monza Italy

Department of Thoracic Surgery Slovak Medical University University Hospital Bratislava Bratislava Slovakia

Department of Thoracic Surgery St James's University Hospital Leeds UK

Department of Thoracic Surgery Tongji University Shanghai Pulmonary Hospital Shanghai China

Department of Thoracic Surgery University Hospital Hradec Kralove Hradec Kralov Czech Republic

Department of Visceral Transplant and Thoracic Surgery Medical University Innsbruck Innsbruck Austria

Division of Thoracic and Transplant Surgery Fondazione Ca' Granda Ospedale Maggiore Policlinico Milan Italy

Division of Thoracic Surgery Campus Bio Medico University of Rome Rome Italy

Division of Thoracic Surgery University of Debrecen Debrecen Hungary

Faculty of Medicine St Petersburg State University Saint Petersburg Russia

Medish Centrum Alkmaar Alkmaar Netherlands

Minimally Invasive Thoracic Surgery Unit Department of Thoracic Surgery Coruña University Hospital Coruña Spain

Thoracic Surgery Unit Istituto Clinico Humanitas CCO Catania Catania Italy

Thoracic Surgery Units Sheffield Teaching Hospital Sheffield UK

Eur J Cardiothorac Surg. 2020 Mar 1;57(3):612. doi: 10.1093/ejcts/ezz221. PubMed

Eur J Cardiothorac Surg. 2020 Mar 1;57(3):612-613. doi: 10.1093/ejcts/ezz220. PubMed

Eur J Cardiothorac Surg. 2019 Sep 1;56(3):628-629. doi: 10.1093/ejcts/ezz229. PubMed

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