To assess feasibility and efficacy of the technique for bilateral thoracic sympathectomy in supine and seated position of the patient, under tracheal intubation instead of selective intubation for anesthesia.The classic technique for bilateral thoracic sympathectomy used to be complex because lateral decubitus alternance, selective intubation and chest drain after the procedure.
From may 2007 to November 2008 we operated upon 36 patients (72 sympathectomies) to treat palmar or palmar and axillary hyperhidrosis. We put them under general anesthesia through tracheal intubation, seated at the operating table, videothoracoscopy with 2 ports of 5 mm diameter, doing intermittent apneas to achieve ultrasound section of the sympathetic chain at T3 (palmar) or T3 and T4 (palmar and axillar) levels. We did'nt let any drain after the operations.
The technique was always feasible. We never had to switch to selective intubation. In two patients we needed to drain one hemithorax because of air leaks to avoid pneumothorax. The endoscopic vision was excellent in all cases, thanks to the lung falling during intermittent apneas because of the seated position. The clinical results have always been all right.
The technical procedure has been feasible and effective.
We can recommend the use of this methods for videothoracoscopic sympathectomy.
Emilio Canalis, No Financial Disclosure Information; No Product/Research Disclosure Information