Robotic Transthoracic Thoracic Duct Ligation
Historically, thoracic duct ligation has been performed by thoracotomy. The video-assisted technique has offered possibilities, but because of the thoracic duct location deep in the mediastinum and the challenges related to patient’s anatomy, the robotic approach offers the consistent opportunity of performing a very precise procedure in often a confined space despite the anatomical variability. The most common location chosen for thoracic duct ligation is just as it enters the mediastinum from the retroperitoneum and just deep to the rightward and vertebral area behind the descending aorta. Medial retraction of the aorta provides the best exposure for a complete ligation. Many advocate a mass ligation; although some recommend dissection to identify the duct for accurate and precise ligation.
KeywordsChylothorax Pleural effusion Esophagectomy Chyloma Chylomicrons Octreotide Somatostatin Lymphangiogram Pleurodesis Povidone-iodine
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