Clinical experience with video-assisted thoracic sympathectomy through the retrosternal pulmonary junction Hidehiro Yamamoto, MD, Masayoshi Okada, MD,

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Presentation transcript:

Clinical experience with video-assisted thoracic sympathectomy through the retrosternal pulmonary junction Hidehiro Yamamoto, MD, Masayoshi Okada, MD, Akio Kanehira, MD, Akitoshi Yamada, MD, Munenori Kawamura, MD The Annals of Thoracic Surgery Volume 68, Issue 6, Pages 2361-2363 (December 1999) DOI: 10.1016/S0003-4975(99)01212-6

Fig 1 (A) The scope guide is a curved aluminum tube with an external diameter of 5.5 mm. There is some clearance between the flexible scope and internal lumen. There is a slit (arrow) in the middle through which air in the left pleural cavity can move into the right when right lung ventilation is switched to the left. (B) A postoperative photograph of the wound of a 20-year-old female with PH. The skin incision was determined, for its cosmetic outcome, by the patient preoperatively because the area could be covered by swimwear. The Annals of Thoracic Surgery 1999 68, 2361-2363DOI: (10.1016/S0003-4975(99)01212-6)

Fig 2 The value of perfusion from intraoperative monitoring using a laser Doppler flow meter demonstrated a remarkable and temporary decrease of microcirculation in the skin of the finger after a electrocoagulation test (arrow) of the sympathetic trunk. The Annals of Thoracic Surgery 1999 68, 2361-2363DOI: (10.1016/S0003-4975(99)01212-6)

Fig 3 (A) The retrosternal pulmonary junction is usually noted in chest computed tomographic scan (arrow). There are usually thin bilateral parietal pleura and fat tissue. (B) A demonstration of this technique was performed using a cadaver. The arrow indicates the second thoracic sympathetic trunk. The scope guide brought an adequate visualization to the endoscopic thoracic sympathectomy. The Annals of Thoracic Surgery 1999 68, 2361-2363DOI: (10.1016/S0003-4975(99)01212-6)