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Recognition of thoracic injuries during trauma assessment must be a priority due to the potential severity of intrathoracic or intrabdominal lesions. While primary care is carried out following the Advanced Trauma Life Support (ATLS) protocols, special attention must be taken to detect life-threatening conditions such as tension pneumothorax, pericardial tamponade or massive hemothorax, guided by clinical suspicion, assessment of the trauma mechanism and noninvasive imaging techniques available in situ or in the emergency department. Chest X-ray and bedside ultrasound (focused assessment in sonography for trauma, FAST) are the initial tests for unstable patients, higher clinical suspicion or high-energy mechanism of accident. After initial resuscitation, during the secondary surgery, chest computed tomography (CT) is the cornerstone test for assessing the presence of intrathoracic lesions secondary to penetrating or highenergy trauma, that can potentially threaten patient's life. Concise and early detection can be life-saving and determines the final results. In this article we review these techniques and their indications.

Uniportal video-assisted thoracoscopic surgery (VATS) is probably the most successful singleincision approach worldwide, probably secondary to several specific circumstances: multiportal VATS was hardly getting his recognition in the thoracic surgeon's community; the extraordinary effort by his creators and believers for developing the technique and giving massive diffusion; the subjective feeling by surgeons who performed the approach about its benefits and advantages. Despite this, many efforts have focused on extending new indications and describing variations of the original intercostal uniportal VATS, but few quality papers have analyzed the real impact of the approach and its real advantages or disadvantages comparing to multiportal VATS. Thus, many surgeons still feel little confidence on the approach and reject his performance. With the aim of standardizing the approach and the technical aspects for nonexperienced or beginners, the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgery (ESTS) decided to set the basis for homogenization of the technique to cement the development of high-level evidence works that shed light on the real outcomes of uniportal compared to multiportal VATS. This article describes the main specific technical aspects while performing lower lobectomies and lymphadenectomy, which were described as the most suitable cases for initiating the learning curve.

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