[Endoscopic elecrocautery of the thoracic sympathetic chain: a minimal invasive surgical treatment]

The thoracic sympathectomy was performed with standard laparoscopic and urologic equipment. After intubation, the patient was placed in a half sitting position. A Surgineedle was introduced into the pleural cavity through a 1 cm incision at the intercostal space between the first and second rib. An apical pneumothorax was created by insufflation of two litres of CO2. A 24 ch. urological trocar was inserted through the same incision, then the electroresectoscope was introduced into the pleural cavity. The sympathetic chain could be observed through parietal pleura riding on the costovertebral junctions. These areas were electrocoagulated. The lung was expanded by limiting expiration and sucking CO2. A postoperative chest X-ray was done to check no pneumothorax. This method was a simple and safe surgery, which was available for bilateral sympathectomy.