Reconstruction of the Sympathetic Chain

Thorac Surg Clin. 2016 Nov;26(4):427-434. doi: 10.1016/j.thorsurg.2016.06.007. Epub 2016 Aug 4.


There is a small subset of patients who have undergone endoscopic thoracic sympathectomy for hyperhidrosis or facial blushing who are dissatisfied and would wish reversal. Compensatory sweating is the most common side effect that causes a person to regret surgery. Treatment options are limited and usually not effective in patients with severe side effects from sympathectomy. Nerve graft interposition has been proven to be effective in experimental models and small clinical series. Da Vinci robotic nerve graft reconstruction with interposition graft and direct suturing of nerve and high magnification dissection most closely mirrors standard nerve reconstruction principles when done as a minimally invasive procedure.

Keywords: Da Vinci robot; Interposition graft; Nerve reconstruction; Video-assisted thoracic sympathectomy.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Ganglia, Sympathetic / physiology
  • Ganglia, Sympathetic / transplantation*
  • Humans
  • Hyperhidrosis / surgery*
  • Nerve Regeneration
  • Plastic Surgery Procedures / methods*
  • Reoperation
  • Robotic Surgical Procedures / methods*
  • Sympathectomy*
  • Thoracic Surgery, Video-Assisted*
  • Treatment Outcome