Non intubated VATS: where do we stand?

Video-assisted thoracic surgery (VATS) is currently being used to diagnose and treat several intrathoracic conditions with minimal morbidity, reduced hospital stay and possibly costs reduction compared with standard open surgery. Moreover, uniportal VATS (uniVATS) is emerging as a new, feasible and safe procedure capable to offer the same advantages compared with multiportal approaches; the addition of non intubated techniques may indeed pave the way to an innovative fast tracking concept. In recent years many authors focused on the possibility to avoid side-effects of intubated general anesthesia as well, in order to maintain more physiologic muscular, neurological and cardiopulmonary status in order to reduce the procedure-related traumas leading to fasten recovery and optimized outcomes. This is a review of the pertinent literature regarding this technique.