Retroperitoneal endoscopic lumbar sympathectomy: laboratory and clinical experience

Retroperitoneal endoscopic lumbar sympathectomy was performed in four pigs in the prone or lateral position to study the feasibility of these new approaches. Positioning, port placement and the dissection technique are described in detail. In nine patients retroperitoneal endoscopic lumbar sympathectomy, using the lateral position technique, was performed. The importance of port placement and dissection techniques for visualisation of the sympathetic chain are emphasised. The endoscopic retroperitoneal approach enables the sympathetic chain to be accurately localised whilst enhanced endoscopic vision aids dissection. Retroperitoneal endoscopic lumbar sympathectomy is a feasible technique offering patients the benefits of the minimally invasive approach.