Endoscopic Sympathectomy

Denervation of the sympathetic nerve can be accomplished with much less operative trauma by using the endoscopic surgical approach. Although endoscopic thoracic sympathectomy is not new, the techniques and the extent of denervation have not been standardized. The anatomic appearances and configurations of the sympathetic chain are explained, and various procedures, including ramisections, interganglionic sympathectomy, and ganglionectomy, are reviewed. Thoracoscopic approaches, operative techniques, and potential complications are discussed.