DOI: 10.36347/sjmcr.2018.v06i11.021

Pages: 988-990

The role of VATS is still being defined in the management of thoracic trauma. We report three cases of iatrogenic thoracic injury managed at our hospital via VATS. The first patient is a 35-year old man who developed tension haemothorax after pleural tapping for parapneumonic effusion. VATS was arranged to evacuate the haematoma and arrest bleeding from a right middle lobe artery via intracorporeal suturing. The second patient is a 68-year old lady who developed pneumothorax on the contralateral hemithorax after insertion of an internal jugular vein catheter for dialysis. The catheter was removed under direct vision during VATS, and the pleural defect was sealed with histoacryl glue and sutured intracorporeally. The third patient is a 34-year old lady who had a complicated surgery for a ruptured ectopic pregnancy. She developed nosocomial pneumonia with effusion which required a chest drain insertion. This was complicated with massive haemothorax. VATS was performed to evacuate the clots and cauterise the bleeding areas on the parietal pleura. All 3 patients did not require conversion to open thoracotomy; and made good recovery post operatively. In haemodynamically stable patients with thoracic injuries, VATS provides an accurate assessment of intra-thoracic organ injury and can be utilized to definitively and effectively manage injuries sustained as a result thoracic trauma. It gives the advantage of less pain, reduced post op pain and smaller scars when compared to thoracotomy.