Sympatholysis via thoracoscopy

Abstract

Thoracic sympathectomy is defined as the anatomical interruption of the thoracic sympathetic chain. The level of interruption (e.g., T2, T3) depends upon the indication for the sympathectomy and the required therapeutic effects (e.g., treatment of essential palmar or axillary hyperhidrosis, treatment of refractory heart rhythm disorders, treatment of chronic pancreatic pain). Anatomically, the interruption can be applied at the preganglionic level; however, current best practice involves ablation by electrocautery (“sympatholysis”) or excision/clipping of the sympathetic ganglia (and sometimes part of the chain itself) (Noppen 2004; Tassi et al. 2006).