Thoracoscopic Repair of Long-Gap Esophageal Atresia Using the Thoracoscopic Internal Traction Technique: A Challenging Feat

Long-gap esophageal atresia (LGEA) is an abnormality in the development of the esophagus resulting in the disruption of the continuity of the esophageal lumen with no feasible primary repair due to the "long gap" between two esophageal stumps. There is controversy regarding both the precise definition and the treatment protocol of this congenital condition. Methods such as delayed primary repair, open external traction, thoracoscopic external traction, and thoracoscopic internal traction were used in the treatment of patients with varied outcomes. Thoracoscopic internal traction was employed in the treatment of the described patient, who had a good functional outcome. Complications were managed conservatively with no need for additional surgeries. The four-week waiting period between both stages of the surgery made it possible to extubate the patient, forgo the postoperative need for paralysis, and reduce the period of sedation to the minimum. We believe that minimally invasive surgery can be used in the treatment of LGEA with good outcomes, provided the surgeon has sufficient experience.