Single-Port Video-Assisted Dorsa Single-Port Video-Assisted Dorsal Sympathectomy (Uniportal) Hussein Aboob Al-Kabi* FICMS, Tahseen Mezher Hashim** FICMS, Looiy Mohammed AL-Hallaq* FICMS

  • imj Iraq Medical Journal
Keywords: Sympathectomy, Thoracoscopy, Ischemia, Hyperhidrosis.


Background: In the last 15 years, video-assisted thoracic surgery has been rapidly become a milestone in the thoracic surgical armamentarium. It is performed through a single port (uniportal) pursues the same objectives of the standard video-assisted thoracic surgery with even less invasiveness due to the involvement of only one intercostal space. Dorsal sympathectomy is indicated for a variety of sympathetic disorder, but it is most commonly performed for hyperhidrosis. Reflex sympathetic dystrophy, upper extremity ischemia, Raynaund’s disease, debilitating facial blushing, and splanchincectomy for pancreatic pain are less common indication.

Objectives: To study the benefits of single port video-assisted thoracic surgery over multiple ports in sympathetic and ischemic disorders. Methods: Ten patients were operated upon at Ibn-Alnafees hospital from the 1st of January 2008 to 28th of February 2017 by single port dorsal sympathectomy, 5 males and 5 females with mean age of 35.5 ranges from 22-70 years. They suffered from primary focal hyperhidrosis and severe upper extremity ischemia, which were un suitable for revascularization. Five of these patients had Raynaund’s, two primary focal hyperhidrosis, one Buerger disease, one emboli, one causalgia, one male patient operated upon bilaterally at same session. They anaesthetized using one lung anaesthesia and under-went single-port videothoracoscopy. Sympathetic chain resection was limited to T2-T3 or T3-T4.

Results: In this study 10% of the patients bilateral sympathectomy done for them, unilateral right sided done for 40% and left sided for 50%. In 90% of patients there were no intraoperative or early postoperative complications. Ten per cent of the patients had pneumothorax postoperatively. Hospital stay ranged from 1-5 day.

Conclusion: Video-assisted thoracic surgery performed through a single port (unilateral) had excellent result in treating palmer hyperhidrosis with no recurrence “on short term follow-up”, and good results for painful ulcerated upper limbs that not improved by medical therapy


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