Abstract
Chylopericardium is very rarely encountered in clinical practice. The common causes are post cardiac or thoracic surgery and neoplasms of the mediastinum. Most of the time, no cause is attributed and it is labelled as primary idiopathic chylopericardium. Conservative management is usually not successful and definitive surgery is required. The recommended surgery is creation of a pericardio-pleural window and thoracic duct ligation. We demonstrate that this procedure can be easily accomplished by uniportal video-assisted thoracic surgery (U-VATS).