Management of intraoperative bleeding in the video-assisted thoracoscopic surgeries

Minimally invasive approach using video-assisted thoracoscopic (VATS) to lung and esophageal cancer resection offers enormous benefits over open surgery. Yet, the intraoperative bleeding is still a primary cause of conversion to open surgery as well as a major risk for VATS surgery. We present two cases of intraoperative bleeding during thoracoscopic lobectomy and esophagectomy. Ethical approval was obtained from the institutional ethics board. Thoracoscopic management of intraoperative bleeding was demonstrated in different operations. Calm maintenance of a clear thoracoscopic view and prompt establishment of bleeding control, may allow for suture repair of injured vessels. Despite intraoperative bleeding remains the most challenging risk factor, proper management renders minimal invasive approach safe and effective for vasculature repair.