Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model

Background A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an inte...

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Veröffentlicht in:The international journal of medical robotics + computer assisted surgery 2008-09, Vol.4 (3), p.258-262
Hauptverfasser: Latif, M. J., Afthinos, J. N., Connery, C. P., Perin, N., Bhora, F. Y., Chwajol, M., Todd, G. J., Belsley, S. J.
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Sprache:eng
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Zusammenfassung:Background A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an intercostal nerve graft using the da Vinci robot. Methods A robotic swine model was established using single‐lung ventilation and four ports. The pleura was incised and a representative segment of sympathetic chain was transected. A nearby intercostal nerve was harvested and sutured to the sympathetic chain using four interrupted 10‐0 nylon sutures on the epineurium. Results The intercostal nerve was an excellent size match and post‐procedure necropsy yielded successful anastomoses without apparent complications. Conclusions Robotic intercostal nerve grafting for reversal of thoracic sympathectomy is technically feasible. The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain. Copyright © 2008 John Wiley & Sons, Ltd.
ISSN:1478-5951
1478-596X
DOI:10.1002/rcs.205