Abstract
High-output Chyle leak is a dreadful complication following neck dissection, posing challenges in management due to the morbidity associated with prolonged leakage. This case series describes the efficacy of a novel Indocyanine Green (ICG) Fluorescence-guided Robotic Transthoracic thoracic duct ligation technique in intractable high-output chyle leaks following neck dissection. Three patients with persistent high-output chyle leaks following neck dissection underwent robot-assisted thoracic duct ligation. Preoperative evaluation, surgical technique, postoperative care, outcomes and follow-up were recorded. All patients experienced successful resolution of chyle leaks with no intraoperative complications. Postoperative recovery was uneventful, and no recurrences were observed during the follow-up period. ICG-guided robotic transthoracic thoracic duct ligation is a safe and effective method for managing persistent high-output chyle leaks following neck dissection, offering a minimally invasive technique with favourable outcomes.