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Robotic Ligation of Thoracic Duct
A 41-year-old woman developed high output (2 L/day) left chylothorax following the resection of a bronchogenic cyst. Treatment with octreotide (100 mcg SC bid) and nothing by mouth status with total parenteral nutrition was unsuccessful after seven days. The patient underwent a right robotic thoracic duct ligation using the da Vinci Xi robot.
In the left lateral decubitus position, the port was placed anterior to the tip of scapula, with the camera port in the sixth interspace on the anterior axillary line, at the level of the diaphragm midway between anterior and midaxillary line. Upon ligation of the duct, chest tube output ceased. The patient was discharged on postoperative day two.
Cerfolio R. Ligation of the Thoracic Duct for Chylothorax. https://www.ctsnet.org/article/ligation-thoracic-duct-chylothorax. Published October 6, 2009. Accessed March 30, 2018.