Management of intraoperative bleeding during video-assisted thoracoscopic surgery

Thoracic procedures are increasingly being performed using video-assisted thoracic surgery (VATS), which has become the leading surgical approach for lung cancer in Japan. Therefore, thoracic surgeons must have the ability and experience to tackle bleeding during VATS. Here we discuss the prevention, preparation, classification, and management of intraoperative bleeding during VATS. Additionally, we present our institute’s algorithm for decision-making if bleeding occurs during the procedure and demonstrate cases of hemostasis achieved by the use of sealants that are commonly used in Japan.