LUMBAR SYMPATHECTOMY BY MEANS OF RETROPERITONEOSCOPY

Initial attempts at endoscopic lumbar sympathectomy were made 20 years ago. Failure was guaranteed since the retroperitoneal approach did no t 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 1.5 l of saline, thereby creating a cavity which is then maintained by ins ufflation of CO2. Following this manoeuver, orientation proves easy an d the approach to the sympathetic chain becomes a straightforward proc edure. Both left and right-sided endoscopic lumbar sympathectomy has b een successfully performed with this new technique in one patient each .