Is a complicated VATS lung resection better than no VATS at all?—converting our stance on intraoperative conversions

Since its introduction in the early 1990s, video-assisted thoracoscopic surgery (VATS) has been the focus of several technological advances, improvements in technique, and increased utilization (1,2). Compared to open thoracotomy, VATS lung resections are associated with improved outcomes of reduced postoperative morbidity and length-of-stay without evidence of inferior long-term survival or disease recurrence (3-5). However, one potential barrier to increased adoption of VATS into routine practice is the concern for requiring an intraoperative conversion.