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Lasers for Endoscopic Thoracic Sympathectomy ?

By: Hratch Karamanoukian, MD and Raffy Karamanoukian, MD

July 30, 2008

Can a Laser be Used to Perform Endoscopic Thoracic Sympathectomy ?


Researchers at the Department of Vascular Surgery, St Peter's Hospital, Chertsey, Surrey, UK have reported a study where laser technology was used to destroy the thoracic sympathetic nerve as opposed to diathermy (heat energy). As is known, thoracic symathectomy is performed by cutting the nerve, burning the nerve (diathermy) or clipping the nerve. The surgeon performed a total of 233 thorascopic sympathectomy procedures in 123 patients between 1987 and 2006. The lead researcher, Dr. Black, concluded that “thorascopic sympathectomy is safe and can be carried out as a single bilateral procedure in the majority of cases. The laser allows the use of a single port, requires less dissection than surgical or clipping techniques, is more precise than diathermy and may be less likely to cause a Horner's syndrome”. The study was reported in the Annals of the Royal College of Surgeons of England, volume 90, March 2008 (pages 142-145).

Dr. Karamanoukian comments – I believe that there is no need to use a laser to perform sympathectomy as titanium clips are superior to techniques used to destroy the nerve, whether by diathermy, cutting or laser. If one is going to use diathermy, there is risk of Horner’s syndrome which is unlikely or impossible with clips.


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For more information about hyperhidrosis (excessive sweating) , as well as surgical and non-surgical hyperhidrosis treatment options, contact Dr. Karamanoukian at The Center for Excessive Sweating, a National Center of Excellence for Hyperhidrosis Treatment by email or by phone at (716) 839-3638.

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