Lumbar sympathectomy by means off retroperitoneoscopy

Abstract

Initial attempts at endoscopic lumbar sympathectomy were made 20 years ago. Failure was guaranteed since the retroperitoneal approach did not provide sufficient space for orientation. Recently, a new method of retroperitoneoscopy has been described. Initially, the retroperitoneum is opened with the aid of a balloon which is inflated with about 1.51 of saline, thereby creating a cavity which is then maintained by insufflation of CO_2. Following this manoeu-ver, orientation proves easy and the approach to the sympathetic chain becomes a straightforward procedure. Both left and right-sided endoscopic lumbar sympathectomy has been successfully performed with this new technique in one patient each.