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Objective: Video-assisted thoracic surgery (VATS) has been deemed an acceptable and effective minimally invasive approach to treat a multitude of intra-thoracic conditions. More recently there has been an increasing use of VATS for removal of foreign bodies. There have been only a few similar reported cases in the literature. We report our experience and favorable outcome in removing traumatic foreign bodies in 10 cases from war zones in the Middle East and North Africa, representing the largest reported cohort from this region.

Methods: A cohort of 10 patients with war-related injuries and foreign body objects in the chest cavity were referred to our minimally invasive thoracic surgery service. All patients were hemodynamically stable at the time of referral, but had foreign-body related complications including empyema, loculated effusions and retained hemothorax. A 3-port VATS was performed for all patients, without the need of open thoracotomy in any of them.

Results: A 3-port VATS was used to successfully remove the foreign bodies and address the associated complications in all 10 patients. All patients made excellent recovery.

Conclusions: VATS when performed by a dedicated minimally invasive thoracic surgery team can be safe and at least as effective in treating trauma related foreign bodies in the chest cavity as open thoracotomy, if not better. Further studies to compare VATS to open thoracotomy in such circumstances, are needed.