Cisterna Chyli Ablation

This procedure is often combined with “thoracic duct ligation” and “sub-total pericardectomy” to treat dogs with Idiopathic Chylothorax. Chylothorax is a condition whereby lymphatic fluid drains into the chest, surrounding the lungs and making it difficult to breath. The majority of these cases are termed idiopathic meaning that the cause of the fluid accumulation is unknown but through years of research and experience a combination of surgical techniques have been developed to treat this condition. One of those techniques is “Cisterna Chyli Ablation” (CCA). The cisterna chyli (CC) is a lymphatic reservoir situated dorsal and to the right side of the abdominal aorta. Lymphatic fluid drains from the intestines into the CC and then continues flowing forward into the thoracic duct. Abnormalities in the thoracic duct are hypothesized to lead to chyle leakage into the chest. CCA aims to destroy the CC and allow the chyle to drain into the abdomen where it is easily and efficiently absorbed by the omentum. Traditionally this procedure is performed by an “open approach” necessitating the need to open the entire abdomen and usually requires an assistant for retraction of organs so that the CC can be visualized. Laparoscopic CCA however is performed in sternal recumbency. This allows nearby organs (right kidney, intestines etc) to hang by gravity exposing the site of surgical interest, and providing an unparalleled and magnified visualization of the CC for surgical ablation.