Surgical simulation for safe uniportal VATS

An established trend in obtaining a radical anatomical resection through a safe minimally invasive approach has been observed in the recent years. However, since the establishment of the three or more ports video-assisted thoracic surgery (VATS), the interest in the uniportal VATS to lung lobectomy has been gaining a phenomenal and global interest from the thoracic surgeons. A specific training in the uniportal VATS approach is crucial to ensure safety and radical treatment. It should aim at giving the surgeon independence and self-confidence throughout the procedure. The learning curve for a surgical intervention, especially in VATS, whereby surgeons acquire expertise, poses important ethical and medico-legal issues since practice, training and instituting a new surgical procedure is predominantly done on patients who, often, are not totally aware or properly informed. In this field, the role of training becomes mandatory, and simulation is decisive, providing a technological “close to reality experience” and a “hands off the patient” but “hands on the procedure”. A proper training aiming at safeguarding patients but at the same time promoting a standardised, close to reality experience to all thoracic residents during their training, and to those surgeons who wish to learn important advances in technical procedures (uniportal VATS), is presently important but will be a prerequisite in the near future. Industries in the thoracic field are encouraged to develop new technological advances [3D, virtual reality (VR)] which will allow a systematic, progressive, realistic and safe training in this global leap into uniportal VATS.