This special issue of the Journal of Thoracic Diseaseis dedicated for the third year to the ESTS Conference and collects a selection of the most innovative and state of the art invited lectures presented during the 23rd ESTS Annual Congress. Our selection covers most of the aspects that makes up the mission of ESTS and we therefore came up with the following very innovative and sometime controversial contributions presented by world-renown experts in their field: the state of the art of diaphragmatic pacing and stimulation; robotic assisted thoracoscopic surgery for locally advanced lung cancer; non intubated, awake, thoracic surgery; the future of randomized clinical trials comparing VATS versus open surgery; surgery versus stereotactic body radiation therapy (SBRT) for the management of early stage lung cancer; the state of the art and future perspectives of the clinical research in China; when and how to perform eso-coloplasty; tips and tricks to perform vascular access for ECMO; and a trainee perspective of how to organize and manage a VATS training program.
