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Uniportal Approach to Pericardial Window and Sympathectomy

  • Simon C. Y. Chow
  • Calvin S. H. NgEmail author
Chapter

Abstract

Pericardial window creation and thoracic sympathectomy are relatively simple procedures that can be performed by uniportal VATS approach. Successful drainage of pericardial effusion via a pericardial window can improve quality of life of patients and reduce frequency of admissions, while successful elimination of hyperhidrosis can improve patient satisfaction and self esteem. With the evolution of surgical techniques and emergence of uniportal thoracic surgery, excellent procedural outcomes can be achieved while minimizing surgical trauma to patients. In this chapter, we will introduce and describe the latest uniportal approaches to pericardial window and sympathectomy. In addition, technical considerations and select clinical results will also be discussed.

Supplementary material

Video 1

Uniportal VATS pericardial window (WMV 26423 kb)

Video 2

Vasoview uniportal sympathecotomy (WMV 12232 kb)

References

  1. 1.
    Ng CS, Lau KK, Gonzalez-Rivas D, et al. Evolution in surgical approach and techniques for lung cancer. Thorax. 2013;68:681.CrossRefGoogle Scholar
  2. 2.
    Li WW, Lee TW, Lam SS, et al. Quality of life following lung cancer resection: video-assisted thoracic surgery vs thoracotomy. Chest. 2002;122:584–9.CrossRefGoogle Scholar
  3. 3.
    Ng CSH. Uniportal VATS in Asia. J Thorac Dis. 2013;5:S221–5.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Lau RW, Ng CS, Kwok MW, et al. Early outcomes following uniportal video-assisted thoracic surgery lung resection. Chest. 2014;145(Suppl 3):A50.CrossRefGoogle Scholar
  5. 5.
    Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg. 2013;95:426–32.CrossRefGoogle Scholar
  6. 6.
    Rocco G, La Rocca A, La Manna C, et al. Uniportal video-assisted thoracoscopic surgery pericardial window. J Thorac Cardiovasc Surg. 2006;131:921–2.CrossRefGoogle Scholar
  7. 7.
    Song IH, Yum SW, Choi WS, et al. Clinical application of single incision thoracoscopic surgery: early experience of 264 cases. J Cardiothorac Surg. 2014;9:44.CrossRefGoogle Scholar
  8. 8.
    Rocco G, Martucci N, La Manna C, et al. Ten-year experience on 644 patients undergoing single-port (uniportal) video-assisted thoracoscopic surgery. Ann Thorac Surg. 2013;96:434–8.CrossRefGoogle Scholar
  9. 9.
    Ng CSH, Wong RHL, Lau RWH, Yim APC. Minimizing chest wall trauma in single port video-assisted thoracic surgery. J Thorac Cardiovasc Surg. 2014;147(3):1095–6.CrossRefGoogle Scholar
  10. 10.
    Kotzareff A. Resection partielle de trone sympathetique cervical droit pour hyperhidrosis unilateral. Rev Med Suisse Romande. 1920;40:111–3.Google Scholar
  11. 11.
    Kux F. The endoscopic approach to the vegetative nervous system and its therapeutic possibilities: especially in duodenal ulcer, angina pectoris, hypertension, diabetes. Dis Chest. 1951;20(2):139–47.CrossRefGoogle Scholar
  12. 12.
    Askari A, Kordzadeh A, Lee GH, Harvey M. Endoscopic thoracic sympathectomy for primary hyperhidrosis: 16-year follow up in a single UK centre. Surgeon. 2013;11:130–3.CrossRefGoogle Scholar
  13. 13.
    Atkinson LD, Forde-Thomas NC, Fealey RD. Endoscopic transthoracic limited sympathotomy for palmar – plantar hyperhidrosis: outcomes and complications during a 10-year period. Mayo Clin Proc. 2011;869:721–9.CrossRefGoogle Scholar
  14. 14.
    Bell D, Jedynak D, Bell R. Predictors of outcome following endoscopic thoracic sympathectomy. ANZ J Surg. 2014;84(1–2):68–72.CrossRefGoogle Scholar
  15. 15.
    Cerfolio RJ, De Campos JR, Bryant AS, et al. The society of thoracic surgery expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91:1642–8.CrossRefGoogle Scholar
  16. 16.
    Chou SH, Kao EL, Lin CC, Chang YT, et al. The importance of classification in sympathetic surgery and a proposed mechanism for compensatory hyperhidrosis: experience with 464 cases. Surg Endosc. 2006;20:1749–53.CrossRefGoogle Scholar
  17. 17.
    Licht PB, Ladegaard L, Pilegaard HK. Thoracoscopic sympathectomy for isolated facial blushing. Ann Thorac Surg. 2006;11:59–62.Google Scholar
  18. 18.
    Plas EG, Fugger R, Herbst F, et al. Complications of endoscopic thoracic sympathectomy. Surgery. 1995;118:493–5.CrossRefGoogle Scholar
  19. 19.
    Lai CL, Chen WJ, Liu YB, et al. Bradycardia and permanent pacing after bilateral thoracoscopic T2 sympathectomy for primary hyperhidrosis. Pacing Clin Electrophysiol. 2001;24:524–5.CrossRefGoogle Scholar
  20. 20.
    Hutter J, Miller K, Moritz E. Chronic sequels after thoracoscopic procedures for benign diseases. Eur J Cardiothorac Surg. 2000;17:687–90.CrossRefGoogle Scholar
  21. 21.
    Steegers MA, Snik DM, Verhagen AF, et al. Only half of chronic pain after thoracic surgery shows a neuropathic component. J Pain. 2008;9:955–61.CrossRefGoogle Scholar
  22. 22.
    Sihoe AD, Cheung CS, Lai HK, et al. Incidence of chest wall paresthesia after needlescopic video-assisted thoracic surgery for palmar hyperhidrosis. Eur J Cardiothorac Surg. 2005;27:313–9.CrossRefGoogle Scholar
  23. 23.
    Lardinois D, Ris HB. Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach. Eur J Cardiothorac Surg. 2002;21:67–70.CrossRefGoogle Scholar
  24. 24.
    Ng CSH, Yeung ECL, Wong RH, et al. Single-port sympathectomy for palmar hyperhidrosis with Vasoview HemoPro 2 endoscopic vein harvesting device. J Thorac Cardiovasc Surg. 2012;144(5):1256–7.CrossRefGoogle Scholar
  25. 25.
    Ibrahim M, Menna C, Andreettti C, et al. Bilateral single port sympathectomy: long term results and quality of life. Biomed Res Int. 2013;2013:348017.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Kujipers M, Klinkenberg TJ, Bouma W, et al. Single port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach. J Cardiothorac Surg. 2013;8:216.CrossRefGoogle Scholar
  27. 27.
    Ng CSH, Lau RWH, Wong RHL, et al. Single port Vasoview sympathectomy for palmar hyperhidrosis: a clinical update. J Laparoendosc Adv Surg Tech A. 2014;24(1):32–4.CrossRefGoogle Scholar
  28. 28.
    Chen YB, Ye W, Yang WT, et al. Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Chin Med J. 2009;122(13):1525–8.CrossRefGoogle Scholar
  29. 29.
    Ng CSH, Lau RWH, Wong RHL, et al. Evolving techniques of endoscopic thoracic sympathectomy: smaller incisions or less? Surgeon. 2013;11:290–1.CrossRefGoogle Scholar
  30. 30.
    Elia S, Guggino G, Mineo D, et al. Awake one stage bilateral thoracoscopic sympathectomy for palmar hyperhidrosis: a safe outpatient procedure. Eur J Cardiothorac Surg. 2005;28:312–7;discussion 317.CrossRefGoogle Scholar
  31. 31.
    Carillo Gerardo AO, Carretero Miguel AC, Barreiro LP, et al. Nontintubated bilateral single port thoracoscopic sympathectomy in the context of an outpatient program, the least invasive management for hyperhidrosis surgery. Ann Translat Med. 2015;3(22):357.Google Scholar
  32. 32.
    Zhu LH, Du Q, Chen L, Yang S, et al. One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: outcomes and consequences. J Thorac Cardiovasc Surg. 2014;147(1):25–8.CrossRefGoogle Scholar
  33. 33.
    Zhu LH, Chen L, Yang S, et al. Embryonic NOTES thoracic sympathectomy for palmar hyperhidrosis: results of a novel technique and comparison with the conventional VATS procedure. Surg Endosc. 2013;27(11):4124–9.CrossRefGoogle Scholar
  34. 34.
    Zhu LH, Chen WS, Chen L, et al. Transumbilical thoracic sympathectomy: a single-centre experience of 148 cases with up to 4 years of follow-up. Eur J Cardiothorac Surg. 2016;49:i79–83.PubMedGoogle Scholar
  35. 35.
    Chen J-T, Liao C-P, Chiang H-C, et al. Subxiphoid single-incision thoracoscopic bilateral ablative sympathectomy for hyperhidrosis. Interact Cardiovasc Thorac Surg. 2015;21:119–20.CrossRefGoogle Scholar
  36. 36.
    Rocco G. Endoscopic VATS sympathectomy: the uniportal technique. Multimed Man Cardiothorac Surg. 2007;2007(507):MMCTS.2004.000323.  https://doi.org/10.1510/MMCTS.2004.000323.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Division of Cardiothoracic Surgery, Department of SurgeryPrince of Wales Hospital, The Chinese University of Hong KongHong Kong SARChina

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