Management of intraoperative bleeding during thoracoscopic pulmonary resection in Japan

In thoracoscopic surgery, to ensure the safety of the operation and minimize the rate of conversion to thoracotomy, it is important to emphasize appropriate troubleshooting, particularly for intraoperative bleeding, because inappropriate management of significant bleeding can lead to catastrophic and life-threatening consequences. A few studies have focused on surgical techniques for managing massive intraoperative bleeding during thoracoscopic surgery in Japan. Based on the results of these studies, we created a modified treatment algorithm for the management of significant intraoperative bleeding. In this paper, we introduce the concepts of “attachment of a thrombostatic sealant” and “compression of the injury site using the adjacent lung” to our algorithm as useful methods to achieve hemostasis during thoracoscopic surgery, and provide further details of these techniques in accompanying videos.