A 28-year-old male with long-standing GERD were referred to Surgery. Laparoscopic Nissen-Rosetti fundoplication was performed. On postoperative day 5 (POD), the patient went to the Emergency department with retrosternal pain and fever. A CT scan revealed an air-fluid collection in the surgical site. Surgical revision was performed, and drains were placed. Finally, on POD 7, due to suspected perforation, a new endoscopic examination revealed a perforation point in the distal esophagus. The patient's condition worsened, requiring admission to the ICU with respiratory distress. A Vac Stent, with an additional replacement, was placed in the distal esophagus using standard technique. The patient experienced significant improvement and the perforation was resolved in a minimally invasive way.