VATS Empyema Surgery (Video-Assisted Thoracoscopic Surgery for Empyema)

Procedure Overview and Surgical Method

VATS empyema surgery is a minimally invasive procedure used to drain pus and infected fluid from the pleural cavity surrounding the lung. Using video-assisted thoracoscopic surgery, small incisions are made in the chest wall to insert a camera and specialized instruments. This allows direct visualization of the empyema collection, removal of any fibrous membranes, and thorough cleaning of the pleural space to restore lung expansion and prevent complications.

Indications and When Surgery is Needed

This procedure is indicated in cases of advanced pleural empyema that do not respond to antibiotics or simple chest tube drainage. When the fluid becomes purulent and forms loculations that trap the lung, surgical intervention becomes necessary. Empyema is often a complication of pneumonia, especially in elderly or immunocompromised patients, and early intervention helps prevent fibrothorax and respiratory failure.

Steps of the Procedure and Associated Techniques

The surgery involves entering the pleural space with VATS, suctioning out the pus, and breaking down fibrous septations or loculations. In some cases, partial pleural decortication is performed when the lung is completely entrapped. Irrigation with sterile fluids is used to cleanse the cavity, and a chest tube is left in place postoperatively to ensure continued drainage. The procedure is performed under general anesthesia with careful monitoring.

Postoperative Recovery and Care

A chest drain is maintained after the procedure to keep the pleural space clear and promote gradual lung re-expansion. The patient is monitored with imaging to evaluate progress. Respiratory physiotherapy is recommended to improve ventilation and prevent recurrence. In most cases, surgery significantly improves symptoms and prevents long-term complications like fibrothorax or recurrent infections.