RT Book, Section
A1 Davenport, Katherine P.
A1 Kane, Timothy D.
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100433680
T1 Thoracoscopy for Sympathectomy and Spine Exposure
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesssurgery.mhmedical.com/content.aspx?aid=1100433680
RD 2024/04/16
AB For  thoracoscopic  sympathectomy  for  primary  hyperhidrosis  and  thoracoscopic  spine  exposure  for  release  of  thoracic  scoliosis,  video-assisted  thoracoscopic  surgery  (VATS)  offers  several  advantages,  including  shorter  hospital  stay  for  patients  and  lower  morbidity.Surgical  treatment  is  recommended  for  severe  cases  of  primary  hyperhidrosis  or  those  refractory  to  medical  management.  Upper  thoracic  sympathectomy  interrupts  transmission  of  impulses  from  the  sympathetic  ganglia  to  the  sweat  glands  and  can  offer  immediate  and  permanent  relief.Compensatory  sweating  (CS)  occurring  in  the  back,  chest,  and  thighs  is  the  most  common  side  effect  of  thoracoscopic  sympathectomy,  but  the  reported  incidence  and  severity  are  lower  than  in  adults  and  very  few  adolescent  patients  express  regret  for  having  undergone  thoracoscopic  sympathectomy.The  initial  access  for  thoracoscopic  spine  exposure  should  be  just  above  the  level  of  the  central-most  portion  of  the  proposed  release.At  each  level,  the  intervertebral  space  is  entered  by  using  electrocautery  to  incise  the  pleura  and  overlying  fascia  between  the  segmental  vessels  superior  and  inferior  to  the  line  of  incision  and  standard  curets  and  other  extraction  devices  are  used  to  remove  the  disk.When  all  the  selected  disks  have  been  removed,  the  bone  graft  that  has  been  harvested  from  the  iliac  crest  and  morcellated  can  be  packed  into  each  intervertebral  space.