title: Videoscopic supradiaphragmatic thoracic duct division using ultrasonic coagulator.
abstract: Three consecutive male patients underwent videoscopic supradiaphragmatic thoracic duct division using the Harmonic Scalpel with a hook blade (Ethicon Endo-Surgery, Cincinnati, OH, USA) for treatment of chyle leaks that developed after left upper lobectomy, graft replacement of a descending aortic aneurysm and thyroidectomy with concomitant partial sternal resection. The thoracic duct was exposed and divided using just the Harmonic Scalpel. The operations lasted 40, 20 and 18 min. No mortality, morbidity or recurrence occurred during follow-up periods of 27, 17 and 9 months. The Harmonic Scalpel with a hook blade can facilitate supradiaphragmatic exposure of the thoracic duct.
authors.affiliation: Department of Cardiothoracic Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. toshimd@attglobal.net
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanaka
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takamoto
mesh_terms: D000368:Aged; D002913:Chyle; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D013897:Thoracic Duct / Q000293:injuries* / Q000601:surgery; D013906:Thoracoscopy / Q000379:methods*; D014464:Ultrasonic Therapy / Q000379:methods*