VATS empyema management (with VAC) is a minimally invasive procedure performed through small punctures in the chest wall, removing pus and adhesions, and placing vacuum dressing into the pleural cavity to continuously drain inflammatory fluid and speed up recovery. The intervention is indicated for patients with severe forms of purulent pleuritis when normal drainage is insufficient due to thick pus or extensive inflammation. Under camera guidance, the surgeon cleans the pleural cavity, breaks down adhesions, and then inserts a special sponge connected to a negative pressure source inside the cavity. This ensures continuous removal of pus, reduces swelling, and helps the lung expand more quickly, restoring normal breathing.