VATS Pleurodesis (Video-Assisted Thoracoscopic Pleurodesis Surgery)

Procedure Overview and Technique

VATS pleurodesis is a minimally invasive surgical procedure used to treat recurrent pneumothorax, a condition where air leaks into the pleural space causing lung collapse. The procedure is performed using video-assisted thoracoscopic surgery (VATS), allowing the surgeon to visualize the pleural cavity through small chest incisions. The goal is to create a permanent adhesion between the lung (visceral pleura) and the chest wall (parietal pleura) to prevent future air accumulation.

Indications and Conditions Treated

This surgery is indicated for patients with spontaneous recurrent pneumothorax, especially when subpleural blebs are present, or when conservative treatments like chest tube drainage fail. It is also performed in secondary cases such as patients with COPD or pulmonary fibrosis who experience repeated lung collapses. Early surgical intervention helps reduce recurrence and complications.

Mechanism and Types of Pleurodesis

During the procedure, the surgeon identifies and resects any visible blebs, then induces pleural inflammation either mechanically (pleural abrasion) or chemically using agents like talc. This inflammation triggers fibrotic adhesion between the pleural layers, eliminating the space where air can collect. The method used depends on the patient’s condition and surgeon’s preference.

Postoperative Care and Follow-up

A chest tube is left in place after surgery to allow complete lung re-expansion and drainage of air or fluid. The patient is monitored with chest X-rays to ensure the pleurodesis has taken effect. Physical exertion and high-altitude environments should be avoided for several weeks. Most patients experience excellent outcomes, with a very low recurrence rate after pleurodesis.