Future study direction on single port (uniportal) VATS.

Single port or uniportal VATS (uniVATS) has represented an authentic innovation in the setting of the surgical techniques because it has connected the past of a single thoracotomic approach to address all conditions in the chest to a present of patient fast tracking and reduced morbidity for all procedures (1). Unlike a few years ago, skepticism about uniVATS has disappeared to be replaced by solid conviction of feasibility (2-5). Is this enough to warrant widespread application of this technique? The future of clinical research on uniVATS will have to clarify and address (I) the results of uniVATS in terms of morbidity (i.e., pain) and oncological value compared to the current technical standards; (II) the new dedicated and ergonometric surgical dissection instruments gauged to fit the single port should be devised along with a new method of visualization (i.e., 3D) and the possible utilization of safe and effective energy devices for the closure of pulmonary vessels; (III) the use of uniVATS in hybrid OR’s along with the use of the principles of navi-uniVATS—similar to endobronchial navigation; (IV) the resort to robotic uniVATS and NOTES and uniVATS through awake and nonintubated anesthetic management; (V) the assessment of patient satisfaction after uniVATS, modalities of uniVATS teaching, and, last but not least, cost effectiveness of uniVATS.