Introduction: A minimally invasive revolution lead to rapid adoption of VATS techniques into clinical practice. VATS is primarily used for straightforward lobectomies with other modalities reserved for advanced resections and nonstandard situations. We present a case of VATS repair of iatrogenic left main bronchus rupture during routine lobectomy.
Methods. A 68-years-old female presented with biopsy proven 1.7 cm adenocarcinoma of the left lower lobe. Staging workup revealed a localized disease and after comprehensive preoperative evaluation the patient was deemed a surgical candidate and was brought for elective VATS resection.
Results: During otherwise routine left lower lobe lobectomy a dreaded complication of endotracheal intubation - the bronchial rupture has occurred. After extensive deliberation with anesthesia team regarding the ventilation management decision was to proceed with VATS repair under spontaneous respiration with pressure support. Bronchial injury was repaired via VATS approach primarily with pericardial flap reinforcement. Postoperative course was uncomplicated and patient was discharged home on POD 4.
Conclusion: VATS approach might be appropriate for such challenging situations as iatrogenic airway injury. We hope this video advances practical knowledge on the technical aspects of the VATS airway repair.