A word of caution—when uniportal VATS should not be done

Uniportal VATS (U-VATS) is gaining more and more popularity. Herein, we discuss the current status of adoption of the technique and—from a “laggard’s” point of view—some situations when the use of U-VATS should be reconsidered. As we all do lack scientific evidence for the superiority of one minimally invasive approach over the other, these situations reflect a gut feeling rather than solid arguments. The article should raise awareness of currently discussed issues with minimally invasive approaches. Finally, it highlights the need for randomized controlled trials, if we really want to rank minimally invasive accesses.