Why perform uniportal video-assisted thoracic surgery?—multiple considerations

Video-assisted thoracic surgery (VATS) via a single incision for major procedures is taking the specialty by a storm over the past 5 years since its description by Gonzalez et al. (1). The development of this approach originated as a progression of the anterior multiport VATS approach, as expansion of the uniportal VATS experience for intermediate procedures (2), but also as a direct evolution from anterior limited thoracotomies. While posterior VATS approaches never really became widely performed even after more than 20 years of being described, the anterior approach alternative has finally been adopted in recent years as a valid widely offered alternative to thoracotomy (3). However, its expansion has taken the best part of 15 years. One has to wonder what are the reasons to explain the rapid adoption of the uniportal VATS approach in contrast to the slow spread of multiport VATS lobectomies.