VATS is a minimally invasive approach that uses small incisions and a thoracoscope (a type of endoscope) to visualize and repair the fistula.

Procedure Overview:

• Anesthesia: General anesthesia is administered, and the patient is placed in a lateral decubitus position.
• Small Incisions: Three small incisions are made in the chest.
• Thoracoscope Insertion: A camera (thoracoscope) is inserted through one of the incisions to visualize the fistula.
• Repair: The fistula is identified and closed using sutures, staples, or other materials. In some cases, tissue grafts or patches may be used to seal the defect.
• Postoperative Care: As with open surgery, a chest tube may be placed to drain air or fluid from the pleural space. Recovery is generally faster than with open surgery.

Advantages:

• Minimally invasive, leading to smaller scars, less pain, and a quicker recovery time.
• Shorter hospital stay and fewer complications compared to open surgery.

Risks:

• May not be suitable for large or complex fistulas.
• Limited visualization in some cases, which may require conversion to open surgery.