As the global momentum toward minimally invasive surgery and enhanced recovery after surgery (ERAS) accelerates, a landmark international collaboration has officially taken shape. Spearheaded by the National Center for Respiratory Medicine of China, the International Tubeless and Uniportal Society (ITUS) was co-founded by Prof. Jianxing He (China), Prof. Diego González-Rivas (Spain), and Prof. Sheldon Bao (USA), marking a pivotal milestone in the global evolution of thoracic surgery.
The establishment of ITUS signifies that the Tubeless surgical concept—originally developed and refined in China—has advanced beyond technical promotion to become an international, collaborative society. ITUS now stands as a major professional platform for academic exchange, education, and clinical advancement in minimally invasive thoracic surgery.
I. Uniting Leading Minds Across Three Continents
ITUS was jointly founded by three globally respected figures from diverse professional and geographic backgrounds:
Prof. Jianxing He: Director of the National Center for Respiratory Medicine of China, President of the Guangzhou Institute of Respiratory Health, and academic leader in thoracic surgery, oncology, and transplantation. As a recipient of China’s National Science and Technology Progress Award, he is a pioneer of the Tubeless surgical approach and a driving force in its international development.
Prof. Diego González-Rivas: Pioneer surgeon in the world performing uniportal VATS anatomic resections, non-intubated uniportal major pulmonary resections and Unisurgeon Uniportal VATS technique. He has published more than 100 papers describing these procedures and the results in the most important medical journals and textbooks of thoracic surgery.
Prof. Sheldon Bao: Division chief of Thoracic Anesthesioloy in Massachusetts General Brigham Hospital, Harvard Affiliated Hospital. He is a prominent advocate of tubeless anesthesia and a leader in perioperative care innovation.
Together, these three visionaries have spent over a decade promoting and refining the principles of Tubeless and Uniportal minimally invasive thoracic surgery worldwide. With the creation of ITUS, they aim to establish a structured, inclusive, and high-quality platform for global collaboration in training, research, and clinical practice.
Ⅱ. Decades of Progress, Culminating in an International Society
Over the past 30 years, Tubeless thoracic surgery—emphasizing non-intubated anesthesia, minimally invasive surgery, and enhanced recovery—has been increasingly adopted at leading centers across the globe. Since 2010, the Tubeless Uniportal Masterclass series has held 2–3 immersive in-person courses annually on four continents, combining live surgical demonstrations, case discussions, observational learning, and mentorship. These efforts have laid a strong foundation for international standardization and knowledge-sharing, directly contributing to the formation of ITUS.
Ⅲ. Global Launch at ESTS 2025: 118 Surgeons from 46 Countries Join
From May 25 to 27, 2025, ITUS was officially launched at the 33rd meeting of the European Society of Thoracic Surgeons (ESTS) in Budapest, Hungary. The society’s debut was met with enthusiastic response, as 118 thoracic surgeons from 46 countries and regions joined as founding members. The launch was widely regarded as one of the conference’s key highlights.
At the conference, ITUS organized a series of showcases including academic presentations, poster exhibitions, and a live membership drive. These sessions introduced the evolution of Tubeless surgery, current clinical outcomes, operative techniques, and global distribution of practice centers. Many international experts expressed admiration for ITUS and voiced their interest in joining ITUS’s global research collaborations, live surgical broadcasts, and educational exchanges.
One of the most notable new members is Prof. Hiran Chrish Fernando, director of thoracic surgery at Allegheny General Hospital and Professor of Surgery, Drexel University College of Medicine, USA. He is experienced in video-assisted thoracoscopic surgery and robotic procedures for the lung, esophagus, and mediastinum, and he is a major figure in thoracoscopic surgery. He has voiced strong support for the Tubeless concept and wanted to promote its standardization and cross-national collaboration.
Dr. Fernando submitted his membership application on site
Prof. Diego promoted the society at the conference venue
IV. Six Objectives: A Global Strategic Blueprint
ITUS is not merely a platform for promoting surgical techniques—it is a visionary alliance focused on building a sustainable global network, standardized educational framework, and a collaborative research ecosystem. The Society has identified six strategic objectives to drive its mission forward:
? Network Formation – Connect high-volume tubeless/uniportal centers and individual experts across all regions.
? Standardized Education – Refine and share curricula, simulation tools, and assessment criteria for surgeons, anaesthetists, and peri-operative teams.
? Rotating MasterClasses – Continue the MasterClass model through annual on-site courses and live-surgery workshops hosted by accredited centers worldwide.
? Research & Evidence – Launch joint registries, prospective trials, and consensus guidelines to advance evidence-based practice.
? Mentorship & Outreach – Provide short-term fellowships, virtual case discussions, and advisory visits to support early-adopting centers.
? Advocacy & Alignment – Liaise with ESTS, AATS, ASCVTS, and other societies to harmonize standards and promote equitable access to care.
Looking ahead, ITUS will organize annual international congresses, themed symposia, live-streamed surgeries, and technical certification programs—aimed at integrating the Tubeless philosophy into routine surgical practice worldwide.
As Professor Jianxing He noted:" Tubeless is not just a surgical advancement—it represents a patient-centered philosophy. Smaller incisions, faster recovery, and fewer complications — all aimed at providing patients with a better experience. Through ITUS, we aim to spread this vision to every corner of the world and offer better care for patients everywhere."
