• Luca Bertolaccini, Hasan Batirel, Alessandro Brunelli, Diego Gonzalez-Rivas, Mahmoud Ismail, Antonio Martin Ucar, Ng Calvin S H CSH Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China., Marco Scarci, Sihoe Alan D L ADL Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. , Paula A Ugalde, Abu Akar Firas F Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Israel. , Benedetta Bedetti, Sergio Bolufer Nadal, Jury Brandolini, Pierfilippo Crucitti, Attila Enyedi, Hiran C Fernando, Jozsef Furak, Javier Gallego-Poveda, Carlos Galvez-Munos, Ivo Hanke, Miroslav Janik, Peter Juhos, Lidia Libretti, Paolo Lucciarini, Paolo Macrì, Stefano Margaritora, Hamid Reza Mahoozi, Dania Nachira, Alessandro Pardolesi, Vadim Pischik, Dariusz Sagan, Hermien Schreurs, Dmitrii Sekhniaidze, Davide Tosi, Akif Turna, Fernando Vannucci, Marcin Zielinski, and Gaetano Rocco.
• Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy.
• Eur J Cardiothorac Surg. 2019 Aug 1; 56 (2): 224-229.

ObjectivesOur 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.MethodsThe 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.ResultsOverall, 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.ConclusionsThe 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.© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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