Thoracic duct (TD) injuries can carry significant morbidity and mortality to patients. When medical and percutaneous interventions are unsuccessful at cure, open surgical ligation is often necessary but limited by poor visualization of the TD and all the morbidities associated with thoracotomy. We describe here a video-assisted thoracoscopic surgery (VATS) approach to TD ligation that offers the benefits of minimally invasive surgery in addition to improved visualization to optimize success rates. Operative Techniques in Thoracic and Cardiovasculary Surgery 21:152-159
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