Lumbar sympathectomy by means off retroperitoneoscopy

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Abstract
Initial attempts at endoscopic lumbar sympathectomy were made 20 years ago. Failure was guaranteed since the retroperitoneal approach did not provide sufficient space for orientation. Recently, a new method of retroperitoneoscopy has been described. Initially, the retroperitoneum is opened with the aid of a balloon which is inflated with about 1.51 of saline, thereby creating a cavity which is then maintained by insufflation of CO2. Following this manoeu-ver, orientation proves easy and the approach to the sympathetic chain becomes a straightforward procedure. Both left and right-sided endoscopic lumbar sympathectomy has been successfully performed with this new technique in one patient each.