[Video-controlled, retroperitoneoscopic, lumbar sympathectomy and sympathicotomy]

Six patients with arterial occlusions of the legs underwent VRLS: a small incision is made in the flank, the retroperitoneum pushed aside with a 1.5-1-balloon catheter, the lumbar sympathicus endoscopically severed and/or partially excised with video assistance. The intervention was successful in all cases. Excised parts of the sympathetic trunk were demonstrated histologically in four cases. One case of severe bleeding from a lumbar artery was stopped endoscopically, and one patient underwent additional open resection of 2 cm of the sympathetic trunk. Postoperative intestinal paralysis lasted a mean of two days, and hospitalization five days. VRLS has several disadvantages for the surgeon, while its lesser strain and earlier rehabilitation are a definite advantage for the patient.