Thoractic Duct Ligation

This procedure is often combined with “Cisterna Chyli Ablation” 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. 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. Pre-operatively, various imaging studies can be performed to identify the leaking branches of the thoracic duct. Traditionally a thoracotomy or opening of the chest has been required to gain access to the thoracic duct for surgery. Thoracotomy is an invasive and post-operatively painful procedure resulting in extended recovery and hospitalization times. With the use of a thoracoscopy we are able to obtain access to the thoracic duct for surgery using only 3 thoracoscopic cannulas. This minimally invasive approach provides excellent visualization for application of surgical clips (duct ligation) and significantly reduces morbidity in patients undergoing 3 separate surgical procedures under the same anesthesia. In our experience the use of laparoscopy and thoracoscopy in these chylothorax cases also significantly reduces anesthesia and surgical times.