Global Resonance in Tubeless Thoracic Surgery — The 52nd Tubeless Uniportal VATS MasterClass Concludes Successfully

From March 23 to 25, 2026, the 52nd Tubeless Uniportal VATS MasterClass was successfully held at the National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University. A total of 41 professionals—including thoracic surgeons, anesthesiologists, and nursing staff—from 14 countries, including Singapore, Spain, Italy, Russia, Turkey, India, and Costa Rica, gathered in Guangzhou for three days of in-depth academic exchange and hands-on training focused on the latest advancements and clinical applications of tubeless minimally invasive techniques.

Structured around four core modules—theoretical lectures, surgical observation, hands-on training, and a global multi-center MDT symposium—the Masterclass offered a comprehensive journey from concept to clinical implementation, creating a high-level platform for international collaboration and knowledge exchange.

Opening: From Concept to Global Consensus

On the morning of March 23, participants began with a visit to the Medical Big Data Center and the Smart Outpatient Department, gaining firsthand insight into the integration of digital healthcare in thoracic surgery. The opening ceremony followed.

Professor He Jianxing delivered the opening remarks, tracing the evolution of tubeless thoracic surgery from early exploration to clinical maturity. He emphasized that “tubeless” is not merely a technical refinement, but a paradigm shift in perioperative management. He also noted that China is at the forefront of this field and expressed his hope that this Masterclass would further promote its global dissemination.

Professor Diego Gonzalez-Rivas highlighted tubeless technology as a key milestone in the advancement of minimally invasive thoracic surgery. He shared recent progress in international multi-center collaboration and expressed his expectation that such exchanges would accelerate global standardization.

Theoretical Lectures: Bridging Innovation and Practice

Over the three days, a series of lectures delivered by leading experts provided both depth and breadth.

Professor He Jianxing presented Tubeless Technique and VITAL Surgery: Clinical Pathways and Scientific Mechanisms, offering a systematic overview of the application of tubeless techniques in pulmonary, esophageal, and mediastinal surgery, as well as in complex procedures such as tracheal reconstruction, lung transplantation, and heart–lung transplantation. He emphasized that tubeless surgery represents an integrated approach encompassing preoperative evaluation, intraoperative management, and postoperative recovery.

Professor Diego Gonzalez-Rivas delivered a lecture on International Advances in Thoracic Surgery, exploring the evolution of minimally invasive techniques, the integration of intelligent technologies, and optimization of perioperative care, supported by insightful international case analyses.

Professor Li Shuben presented Less is More: Tubeless Uniportal Thoracic Surgery, elaborating on the philosophy of minimalism in surgery and highlighting the importance of precise anesthesia, refined surgical technique, and individualized recovery strategies.

Professor Liang Hengrui introduced the application of artificial intelligence in thoracic surgery, demonstrating its practical and scalable use at the National Center for Respiratory Medicine.

Professor Peng Guilin shared pioneering work on spontaneous breathing anesthesia in lung transplantation and awake ECMO, while Professor Yang Hanyu focused on the practical implementation and key techniques of tubeless anesthesia in cardiothoracic surgery and transplantation.

Surgical Observation: Real-Time Demonstration of Excellence

Participants were divided into groups to observe a series of complex tubeless procedures, including:

· Glasses-free 3D precision wedge resection

· Tubeless segmentectomy

· Tubeless lobectomy

· Tubeless tracheal reconstruction

· Tubeless uniportal complex mediastinal tumor resection

· Tubeless lung transplantation

All procedures were performed without endotracheal intubation, with patients maintaining spontaneous breathing and regaining consciousness immediately after surgery. Through live demonstrations and expert commentary, participants gained a clear and practical understanding of surgical workflows, anesthesia management, and intraoperative coordination.

Hands-On Training: Immersive Learning of Cutting-Edge Technologies

A key highlight of the Masterclass was the seven-module hands-on training program. Participants were divided into two groups (A and B) and rotated through all modules to ensure full engagement and efficiency.

· Glasses-free 3D immersive anatomical visualization

· Metaverse-based precision localization simulation

· Puncture robot-assisted localization training

· Uniportal snake-arm robotic lung nodule resection simulation

· Extracorporeal spontaneous breathing anesthesia simulation combined with 3D thoracoscopic practice

· Lateral position intubation training under video laryngoscopy

· Laryngeal mask airway (LMA) placement and ventilation management

With all modules running simultaneously, participants experienced intensive, interactive training that provided direct exposure to cutting-edge technologies and core techniques in tubeless thoracic surgery.

Global MDT Symposium: Convergence of International Expertise

On the afternoon of March 25, the Global Multi-Center Tubeless Thoracic Surgery MDT Case Symposium served as the academic highlight of the program.

Academician Zhong Nanshan, Professor He Jianxing, Professor Diego Gonzalez-Rivas, and Professor Zhao Jincun delivered keynote remarks. Academician Zhong emphasized the transformative value of patient-centered minimally invasive approaches. Professor He reviewed China’s journey in developing tubeless techniques and called for global collaboration in building standardized training systems. Professor Gonzalez-Rivas shared the latest achievements in international cooperation and encouraged broader participation in clinical research.

Moderated by Professor Li Shuben, the case discussion session featured in-depth analyses of representative international cases. Participants engaged in dynamic discussions on surgical strategies, anesthesia approaches, and complication management, demonstrating the power of multidisciplinary and cross-cultural collaboration.

Closing Ceremony: A Milestone and a New Beginning

The closing ceremony was held on the afternoon of March 25. Academician Zhong Nanshan, Professor Zhao Jincun, Professor He Jianxing, and Professor Diego Gonzalez-Rivas presented certificates and commemorative gifts to all participants.

During the open sharing session, participants reflected enthusiastically on their experiences. Representatives from India, Spain, Costa Rica, and other countries noted that the Masterclass not only deepened their understanding of tubeless techniques but also built a strong platform for international collaboration. Many expressed their willingness to further engage in clinical research and training initiatives.

In his concluding remarks, Professor He Jianxing stated that tubeless technology is transitioning from “technical innovation” to “systematic development.” He encouraged participants to bring their knowledge back to their home institutions and serve as ambassadors of tubeless surgery, advancing global thoracic surgery toward a less invasive, safer, and more efficient future.

The event concluded with a group photo, marking the successful completion of the Masterclass.

Three Days, Lasting Impact

Over the course of three days, 41 participants from 14 countries completed a comprehensive and immersive journey into tubeless thoracic surgery through lectures, live surgeries, hands-on training, and multidisciplinary discussions.

This international gathering not only showcased the latest innovations and clinical achievements in the field but also established a strong platform for global academic exchange and collaboration. As participants return home with new knowledge, skills, and connections, the philosophy of tubeless surgery—less intervention, more possibilities—will continue to expand its global impact.

Tubeless technology, global resonance. We look forward to welcoming you again in the near future.