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Updated: Jul 1, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model
M J Latif1, J N Afthinos, C P Connery
1Department of Surgery, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York 10019, USA.
Background:
A subset of patients who undergo video-assisted thoracoscopic sympathectomy for hyperhydrosis develop post-procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an intercostal nerve graft using the da Vinci robot.
Methods:
A robotic swine model was established using single-lung ventilation and four ports. The pleura was incised and a representative segment of sympathetic chain was transected. A nearby intercostal nerve was harvested and sutured to the sympathetic chain using four interrupted 10-0 nylon sutures on the epineurium.
Results:
The intercostal nerve was an excellent size match and post-procedure necropsy yielded successful anastomoses without apparent complications.
Conclusions:
Robotic intercostal nerve grafting for reversal of thoracic sympathectomy is technically feasible. The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain.
