VATS H-Type Fistula Repair - Technique

Dr. Steven Rothenberg describes his technique for thoracoscopic repair of an H-type tracheoesophageal fistula.  Key steps to the procedure include opening of the apical pleura with a vessel sealer, identification of the esophagus and the trachea, development of a plane between the esophagus and trachea below the fistula, development of a retro-fistula plane, retraction of the fistula with a 2-0 silk suture, division of the fistula with a stapler, coverage of the esophageal staple line with apical fat, and closure of the pleura.