Minimally invasive thoracic surgery
VATS and uniportal thoracic surgery
Minimally invasive access is a route to the operation. Treating the disease correctly remains the goal.
VATS uses a thoracoscopic camera and specialized instruments through small incisions. In uniportal VATS, the camera and instruments share one main working incision.
Choice depends on
- The disease being treated.
- Anatomy and lesion location.
- Expected complexity.
- Oncologic or therapeutic goals.
- Patient safety.
Three possible access strategies
Uniportal, multiportal or open: the best approach depends on the case.
UNIPORTAL
One main incision
Camera and instruments share the same access and may be used for selected procedures when technically appropriate and safe.
MULTIPORTAL
Several small ports
Camera and instruments enter through separate ports. It remains minimally invasive and may be preferable for certain anatomy or complexity.
OPEN
Thoracotomy when needed
Open surgery remains appropriate in selected situations. Choosing or converting to thoracotomy is a safety decision, not a failure.
Procedures that may use VATS
The range is broad, but selection remains individualized.
- Lung and pleural biopsies.
- Pneumothorax surgery.
- Selected empyema procedures.
- Pulmonary nodule resection.
- Selected anatomic lung resections.
- Mediastinal and pleural procedures.
Potential benefits, not guarantees
In appropriately selected patients, minimally invasive approaches may reduce access trauma and support faster functional recovery. Pain, length of stay and recovery also depend on the operation, disease and individual condition.
Academic experience
U-VATS practice has also been studied and published.
Academic work includes a published Dominican series of uniportal video-assisted thoracic surgery and international training in VATS and RATS.
Frequently asked questions
Common questions about VATS and uniportal surgery
Is uniportal always better than multiportal VATS?
No. They are different configurations of thoracoscopic surgery. The best choice depends on the procedure, anatomy, complexity and team experience.
Does VATS mean there will be no pain?
No. Minimally invasive access may reduce access trauma, but every operation can cause postoperative pain.
Can VATS be converted to open surgery?
Yes. Conversion may be needed for safety, anatomy, bleeding, adhesions or other findings. It is a surgical decision, not a failure.
Can lung cancer be treated with uniportal VATS?
In selected patients, yes, when the approach can meet oncologic and safety goals appropriately.
Medical authorship and review
Dr. Hernán Oliu Lambert · General and thoracic surgery · Updated and medically reviewed August 30, 2026. Educational content; it does not replace an individual medical evaluation.
Next step
First define the right operation; then choose the best access.
Educational content. It does not replace an individual medical evaluation.