VATS empyema management (without VAC) is a minimally invasive procedure performed through punctures in the chest wall, during which accumulated pus is removed and adhesions preventing lung expansion are dissected with further drainage placement. The intervention is recommended for patients with purulent pleuritis (empyema)—a condition where pus accumulates in the cavity between the lung and chest wall, leading to adhesions, limiting proper lung expansion, and causing shortness of breath. Under video guidance, infected areas and adhesions are removed, pleural cavity lavage is carried out, and drains are placed. As a result, lung function is restored, and inflammation is reduced.