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A 2,045-gram, ex-35 week female with a history of CHARGE syndrome in mild respiratory distress underwent thoracoscopy for what was preoperatively believed to be a Gross type C tracheoesophageal fistula. After ligation of the distal fistula, ventilation remained challenging and intraoperative flexible bronchoscopy through the endotracheal tube revealed a proximal fistula. The proximal fistula was in an H-type configuration high in the thoracic inlet. The video describes the surgical technique used to repair both fistulae and the esophageal atresia thoracoscopically.
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