OBJECTIVES: To provide a short overview of fast-track VATS and to identify areas requiring further research.
DESIGN: A literature search was made using key words including: fast-track, enhanced recovery, video-assisted thoracoscopic surgery (VATS), robot-assisted thoracoscopic surgery (RATS), robotic, thoracotomy, single-incision, uniportal, natural orifice transluminal endoscopic surgery (NOTES), chest tube, air-leak, digital drainage, pain management, analgesia, perioperative management, anaesthesia and nonintubated. References from articles were screened for further articles. Using abstracts, areas of interest for developing a fast-track protocol were selected.
RESULTS: Minimally invasive approach can be divided into several surgical methods, which need further research to establish superiority. The role of intubation has to be further examined, as well as the role of chest drains. Multimodal analgesic treatment including preoperative methylprednisolone seems promising and requires further research.
CONCLUSIONS: The fast track data from other procedures may support future development and improvement of fast track VATS.