Robotic-assisted thoracoscopic thoracic duct ligation with fluorescence imaging with indocyanine green for chylothorax after thoracoabdominal aneurysm repair

Postoperative chylothorax (POC) is an uncommon complication after thoracoabdominal aortic aneurysm (TAAA) open surgical repair. We report the case of a 70-year-old woman previously treated with ascending aorta replacement who presented with a 60-mm extent II TAAA. TAAA open surgical repair was performed. A POC was diagnosed on postoperative day 5. After failed conservative therapy, on postoperative day 24 a robotic-assisted thoracic duct (TD) ligation using indocyanine green fluorescence achieved POC complete resolution, the patient tolerated a full diet and was discharged. At the 3-month clinical follow-up, the patient is well. Robotic-assisted thoracic duct ligation with indocyanine green provided effective minimally invasive treatment with good results.