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Surgical Endoscopy

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01-08-2018 | New Technology

Posterior retroperitoneoscopic thoracic duct ligation: a novel surgical approach

Authors: B. Seeliger, P. F. Alesina, M. K. Walz

Published in: Surgical Endoscopy | Issue 8/2018

Abstract

Background

Treatment of postoperative chylothorax can be challenging. Conservative treatment and/or surgical management by means of open or minimally invasive thoracic duct ligation for persistent chylothorax are accepted therapeutic options. We present a new retroperitoneoscopic approach for thoracic duct ligation.

Methods

Between January 2006 and May 2017, posterior retroperitoneoscopic thoracic duct ligation was performed in four patients. The thoracic duct was identified transdiaphragmatically and ligated cranially to the cisterna chyli using absorbable clips.

Results

Retroperitoneoscopic ligation resulted in a complete and lasting chylothorax resolution in three patients and marked improvement in a fourth one. Mean operative time was 86 min (range 40–135). There were no perioperative or postoperative complications.

Conclusions

Retroperitoneoscopic thoracic duct ligation is feasible and safe. It allows for a precise anatomical exploration of the thoracic duct caudally to the chyle leak, avoiding the previous operative field and resulting in minimal morbidity. In patients with persistent chylothorax, our approach provides an additional therapeutic option.

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Title: Posterior retroperitoneoscopic thoracic duct ligation: a novel surgical approach
Authors: B. Seeliger
P. F. Alesina
M. K. Walz
Publication date: 01-08-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6262-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Posterior retroperitoneoscopic thoracic duct ligation: a novel surgical approach

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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