Uniportal video-assisted thoracic surgery (Uni-VATS)

Uniportal video-assisted thoracic surgery (Uni-VATS) is a minimally invasive surgery that involves accessing the lungs through a single incision. During the procedure, the surgeon creates a small incision, several centimeters wide, between the ribs. This single cut serves as a port for both traditional surgical instruments and the thoracoscope, a long, thin rod attached to a fiber-optic video camera. The thoracoscope allows the surgeon to visualize the pleural cavity and the lungs and conduct the surgery without needing to open the chest wall. Through this single, small incision, the surgeon can perform biopsies or resections of pulmonary tissue, as well as more intensive procedures such as chest wall reconstruction. 

Historically, a sternotomy or thoracotomy was required to perform these procedures, which involved opening the chest with a sternal saw or mechanically spreading apart the ribs to gain access to the pleural cavity, where the lungs are situated. Uni-VATS allows access to the chest via a single incision, which can reduce complications associated with thoracic surgery and improve recovery time.

Who needs a uniportal video-assisted thoracic surgery (Uni-VATS)?

Many of those in need of thoracic surgery could benefit from a minimally invasive approach such as Uni-VATS, which has been proven to be an equally effective procedure for lung tissue biopsies and resections as well as reconstructing the chest wall. 

Uni-VATS can be used to diagnose and treat people with lung cancer and other chest tumors; to remove air or fluid trapped around the lung; and to relieve excess sweating (also known as hyperhidrosis) by targeting certain nerves within the chest.

What are the benefits of uniportal video-assisted thoracic surgery (Uni-VATS)?

Because Uni-VATS is less invasive than traditional open thoracotomies, post-operative recovery tends to be faster, with a shorter length of hospital stay. In addition, studies have shown that minimally invasive thoracic surgeries reduce postoperative pain and the risk of complications compared to open surgeries without affecting outcomes. The Uni-VATS procedure has a cosmetic benefit as well, since it results in only a single, small scar.

What are the alternatives to a uniportal video-assisted thoracic surgery (Uni-VATS)?

Multiple ports can be used in minimally invasive VATS procedures as well, where one incision is made for the surgical instruments and another for the thoracoscope. Additionally, the more traditional open approaches or thoracotomies and sternotomies are available where minimally invasive procedures are not a possibility.

What are the risks associated with a uniportal video-assisted thoracic surgery (Uni-VATS)?

As with all surgeries, Uni-VATS comes with the typical risks of infection and bleeding. Injury to the diaphragm, liver, or spleen can occur due to their proximity to the surgical site. There is also the possibility that the surgeon may intra-operatively decide to switch to an open thoracotomy approach if Uni-VATS proves too challenging. 

Risks unique to VATS procedures include:

  • Burn from the thoracoscope light source 
  • Tumor recurrence at the port site
  • Injury to intercostal nerves