Sequential Extended Thoracoscopic Sympathicotomy for Palmo-Axillo-Plantar Hyperhidrosis Khaled Elalfy, MD, Sameh Emile, MD, Hossam Elfeki, MS, Ahmed.

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Presentation transcript:

Sequential Extended Thoracoscopic Sympathicotomy for Palmo-Axillo-Plantar Hyperhidrosis Khaled Elalfy, MD, Sameh Emile, MD, Hossam Elfeki, MS, Ahmed Elmetwally, MD, Mohamed Farag, MD, Waleed Gado, MD The Annals of Thoracic Surgery Volume 104, Issue 4, Pages 1200-1207 (October 2017) DOI: 10.1016/j.athoracsur.2017.04.035 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Flow diagram for patient recruitment. The Annals of Thoracic Surgery 2017 104, 1200-1207DOI: (10.1016/j.athoracsur.2017.04.035) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Port-site arrangement for extended thoracosopic sympathicotomy and (B) trocar positions. (AAL = anterior axillary line; ICS = intercostal space; PAL = posterior axillary line.) The Annals of Thoracic Surgery 2017 104, 1200-1207DOI: (10.1016/j.athoracsur.2017.04.035) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Operative technique (left side). (A) Retraction of the lung toward the mediastinum. (B) Endoscopic view of the upper part of thoracic sympathetic chain. (C) Incision of the parietal pleura overlying the sympathetic ganglion. (D) Extension of the pleural incision laterally to divide nerve of Kuntz. (E) Transection of the sympathetic chain. (F) Endoscopic view of the last three sympathetic ganglia after ablation. The Annals of Thoracic Surgery 2017 104, 1200-1207DOI: (10.1016/j.athoracsur.2017.04.035) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions