Indocyanine Green and Fluorescence Imaging for Localization of Chyle Leak in Robotic Assisted Thoracic Surgery

John S. Young, MD; Nguyen M. Le, MD; Julissa E. Jurado, MD; Paul C. Lee, MD, MPH

Product Details
Product ID: ACS-5495
Year Produced: 2018
Length: 6 min.


This video highlights the benefit of indocyanine green (ICG) and fluorescence imaging in locating a chyle leak during robotic assisted thoracic surgery for chylothorax. An 82 year old gentleman had undergone a Robotic assisted Right VATS lower lobectomy and mediastinal lymph node dissection for squamous cell cancer. Postoperatively, he developed a high output chylothorax. Given the unlikelihood that this would resolve, he was taken back to the operating room for ligation of his thoracic duct. While in the supine position, ICG dye was injected into his groin and he was given heavy cream through his OGT. By utilizing the fluorescence imaging in conjunction with the ICG dye, we were able to clearly identify that the vast majority of his chyle leak was from station 4R. The lymphatics in this region were clipped and the thoracic duct was ligated near the diaphragm en masse. Fluorescence imaging was again useful in confirming resolution of the chyle leak. The patient did well, his chest tube drainage decreased and was removed and he was discharged home.