Strategy to improve the visualization of the thoracic duct
Posted in Videos on 15 December 2014
Published by Marta Jiménez
Antonio M Lacy (Director of Department of Gastrointestinal Surgery)
Dulce Momblán (Gastrointestinal Surgery Specialist)
Marta Jiménez (Gastrointestinal Surgery Specialist)
Hospital Clínic, Barcelona, Spain
At the Hospital Clínic of Barcelona, all the patients who have an esophageal tumor who require a thoracoscopy for its intervention, receive 500 ml of milk orally 6 hours before surgery.
This simple procedure increases the diameter of the thoracic duct from 1-2 mm to 2-3 mm and changes its appearance to a white bright vessel under thoracoscopy. In case of injury, the chylous fluid also appears as bright white, which facilitates its correct detection, so a subsequent ligation of the chyle leakage can be performed intraoperatively.
In the attached video we show how the thoracic duct can be easily identified thanks to the white appearance of the chyle due to the milk received the night before. Although this is not a standardized procedure, this method allows a better visualization and therefore, a reduction of the morbidity related with the thoracic duct.