A 3.8 kilogram infant boy developed choking with initial feeds. An orogastric tube was curled up at the third thoracic vertebrae on chest radiograph. Echocardiogram was normal, no other obvious physical anomalies existed, thus, there was suspicion of a tracheoesophageal fistula.

On day of life #3,rigid bronchoscopy revealed a single distal tracheoeosphageal fistula 1 centimeter above the carina. The infant was then placed in the left lateral decubitus position, nearly prone, and right side elevated about 30 degrees. 3 trocars were used (1 x 5 mm; 2 x 3 mm) for thoracoscopic repair of tracheoesophageal fistula. Closure of the tracheal fistula and primary esophagoesophageal anastomosis were performed with main tracheal intubation (above the fistula) and 6 mm Hg CO2 pressure instilled for lung collapse and visualization.

The operation took 100 minutes, the infant was extubated 4 hours post-operatively, and esophagram on post-repair day #6 revealed no leak and mild anastomotic narrowing. He was discharged on full feeds on post-operative day #8. At two months follow up he was thriving and gaining weight appropriately.

Thoracoscopic repair of tracheoesophageal fistula can be safely and successfully performed in the newborn.