Handling vascular bleeding without conversion during video-assisted thoracoscopic surgery major pulmonary resection

Bleeding due to vascular injury is the most troublesome and dangerous condition during video-assisted thoracoscopic surgery (VATS) major pulmonary resection. It is also the main reason for emergent conversion to open thoracotomy and remains a great challenge for thoracic surgeons. We designed the suction-compressing angiorrhaphy technique (SCAT) for troubleshooting this problem. Handling of the vascular injury under VATS was divided into three different situations. Herein, three typical videos were presented to elucidate the technical details for the management of vital vascular bleeding during VATS major pulmonary resection.