VIDEO-ASSISTED, RETROPERITONEOSCOPIC, LUM BAR SYMPATHECTOMY AND SYMPATHICOTOMY (VRLS)

Six patients with arterial occlusions of the legs underwent VRLS: a sm all incision is made in the flank, the retroperitoneum pushed aside wi th a 1.5-l-balloon catheter, the lumbar sympathicus endoscopically sev ered and/or partially excised with video assistance. The intervention was successful in all cases. Excised parts of the sympathetic trunk we re demonstrated histologically in four cases. One case of severe bleed ing from a lumbar artery was stopped endoscopically, and one patient u nderwent additional open resection of 2 cm of the sympathetic trunk. P ostoperative intestinal paralysis lasted a mean of two days, and hospi talization five days. VRLS has several disadvantages for the surgeon, while its lesser strain and earlier rehabilitation are a definite adva ntage for the patient.