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Updated: Apr 1, 2026
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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
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Intraoperative bleeding control by uniportal video-assisted thoracoscopic surgery†
Diego Gonzalez-Rivas1, Tomaz Stupnik2, Ricardo Fernandez3
1Department of Thoracic Surgery, Coruña University Hospital and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain diego.gonzalez.rivas@sergas.es.
Summary
Video-assisted thoracic surgery (VATS) allows safe pulmonary resections with low complication rates. Proper planning and team coordination minimize bleeding risks during VATS, reducing the need for open surgery conversion.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Video-assisted thoracic surgery (VATS) has advanced, enabling most pulmonary resections with low morbidity and mortality.
- Effective preoperative planning and meticulous dissection are key to minimizing VATS complications.
Purpose of the Study:
- To highlight the importance of managing intraoperative bleeding during VATS.
- To discuss strategies for controlling hemorrhage and deciding on conversion to open surgery.
Main Methods:
- Review of VATS procedures and complication management.
- Emphasis on preoperative planning, surgical technique, and team coordination.
- Discussion of decision-making regarding conversion to thoracotomy for bleeding control.
Main Results:
- Most VATS complications, especially bleeding, can be managed with proper planning and surgical skill.
- Conversion to open surgery is a safety measure, not a failure, particularly during the learning curve.
- With experience and advanced technology, most bleeding events are controlled via VATS.
Conclusions:
- Careful assessment and management of bleeding are crucial in major thoracoscopic procedures.
- Surgeon experience, operative vision, specialized instruments, and sealants improve bleeding control during VATS.
- Increased VATS experience leads to fewer complications and less conversion to thoracotomy for bleeding.
