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A New Device of Needlescopic Thoracic Sympathectomy Through a Skin Incision

https://doi.org/10.1016/j.athoracsur.2016.11.068Get rights and content

We describe a new technique of performing sympathectomy with a new device. A single skin incision 3 mm long was made in the armpit. The device enables complete resection of the sympathetic segment through a single skin incision, whereas sympathectomy is limited by the use of the conventional needle technique. Even if sympathetic nerves and blood vessels were overlapping, separation of the two organs was performed safely. This device increases the possibility of planning surgical procedures for patients with difficult anatomies.

Section snippets

Technique

From December 2015 to April 2016, 150 patients with palmar hyperhidrosis were treated unilaterally. The mean age of the patients was 27.9 ± 8.5 years (range, 12–55 years). Seventy-seven patients were male, and 73 were female. The equipment used consisted of a thoracoscope 2 mm in diameter (2-mm MiniSite Gold Lapascope, United States Surgical Corporation, and 2-mm K11605AA Miniature Straight Forward, Karl Storz). The new device consisted of three pieces used in accordance with the treatment

Comment

Needlescopic surgical procedure has no clear-cut definition, but it generally involves an operation with appliances of smaller than 3 mm in diameter. Two directions may be taken to reduce surgical invasion; one is to shorten the length of skin incisions, and the other is to decrease the number of surgical access ports. Needlescopic devices are made for the former purpose, and the latter is the ultimate purpose of operations performed through a single skin incision. In accomplishing the two

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Cited by (2)

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    Citation Excerpt :

    The patient was placed in a half-sitting position with arms abducted. Equipment included a thoracoscope, 2 mm in diameter (2-mm MiniSite Gold Laparoscope, United States Surgical Corporation, Norwalk, Conn, or 2-mm K11605AA Miniature Straight Forward, Karl Storz, Tuttlingen, Germany) and needle surgery devices consisting of 2 or 3 pieces used in the manner described by Yamamoto et al.4,5 A 3.0-mm skin incision was made on the midaxillary line in the armpit.

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    2023, SSRN
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© 2017 by The Society of Thoracic Surgeons Published by Elsevier