Reinforcement Mesh Repair for Persistent Pleural Leakage Following VATS Lobectomy: A Case Report and Clinical Insights

Early chest drain removal and discharge are standard in enhanced-recovery protocols after video-assisted thoracoscopic surgery (VATS) lobectomy, but rare wound complications may arise. A 71-year-old man underwent uneventful 3-port right VATS lower lobectomy, with chest drain removal on postoperative day 2. Two weeks later, serous fluid leaked through the access wound. Conservative management with antibiotics and re-suturing failed. VATS re-exploration revealed pleural adhesions and 300 mL effusion without lung herniation. A gentamicin-soaked Prolene® mesh was anchored to reinforce the intercostal defect. The patient healed uneventfully with no recurrence. Persistent pleural leakage through a VATS access wound is rare but merits consideration. When conservative measures fail and structural weakness is suspected, mesh reinforcement offers a durable repair option.