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Thoracic splanchnic nerves: implications for splanchnic denervation.

N Naidoo1, P Partab, N Pather

  • 1Faculty of Health Sciences, Department of Anatomy, University of Durban-Westville, Durban, South Africa.

Journal of Anatomy
|January 5, 2002
PubMed
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Anatomical variations in splanchnic nerves, including the greater splanchnic nerve (GSN), lesser splanchnic nerve (LSN), and least splanchnic nerve (ISN), can explain inconsistent results in chronic abdominal pain management. Understanding these variations is crucial for surgical success.

Area of Science:

  • Anatomy
  • Surgical Anatomy
  • Neuroscience

Background:

  • Splanchnic neurectomy offers value in managing chronic abdominal pain.
  • Inconsistent outcomes in splanchnicectomy suggest underlying anatomical variations in splanchnic nerves.
  • Minimally invasive surgical advancements have renewed interest in studying these variations.

Purpose of the Study:

  • To investigate the incidence, origin, and pattern of splanchnic nerves.
  • To establish a predictable pattern of splanchnic neural anatomy for surgical relevance.
  • To inform surgical techniques for thoracoscopic splanchnicectomy.

Main Methods:

  • Dissection of 38 cadavers (6 adult, 14 fetal).
  • Systematic analysis of the origin, course, and variations of splanchnic nerves.

Related Experiment Videos

  • Documentation of the frequency and anatomical distribution of the greater, lesser, and least splanchnic nerves.

    • Main Results:

    • Bilateral asymmetry in splanchnic nerve origin was observed in all cases.
    • The greater splanchnic nerve (GSN) was consistently present; lesser (LSN) and least (ISN) were inconsistent (92% and 55% incidence, respectively).
    • Observed origins: GSN (T6-9, 73%), LSN (T10-11, 29%), ISN (T11-12, 14%). GSN root variation (3-10 roots, T4-11). Intermediate ganglia found in 60% adults and 39% fetuses.

    Conclusions:

    • Significant anatomical variations in splanchnic nerves necessitate a reappraisal of current surgical techniques.
    • The common practice of splanchnicectomy from T5 distally may overlook crucial nerve contributions, potentially compromising outcomes.
    • A detailed understanding of splanchnic neural anatomy is vital for optimizing surgical management of chronic abdominal pain.