Thoracoscopic repair of esophageal atresia with tracheo-esophageal fistula (TEF)

The thoracoscopic repair of esophageal atresia (EA) and tracheo-esophageal fistula (TEF) is an effective method; it is the procedure of choice if performed by an experienced endoscopic pediatric surgeon. The advantage of the thoracoscopic approach is the reduction in musculoskeletal sequelae and a superior visualization of the anatomy within the thoracic cage. This improved visualization is especially true for identification of the tracheoesophageal fistula. This video demonstrates the thoracoscopic approach to EA and TEF. The patient is placed in a left lateral decubitus position, with a slight ventral tilt. The surgeon stands to the ventral side of the patient, with the laparoscopic unit opposite the surgeon.