Skip to main content

Uniportal Approach to Pericardial Window and Sympathectomy

  • Chapter
  • First Online:
  • 756 Accesses

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.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Ng CS, Lau KK, Gonzalez-Rivas D, et al. Evolution in surgical approach and techniques for lung cancer. Thorax. 2013;68:681.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  3. Ng CSH. Uniportal VATS in Asia. J Thorac Dis. 2013;5:S221–5.

    PubMed  PubMed Central  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  10. Kotzareff A. Resection partielle de trone sympathetique cervical droit pour hyperhidrosis unilateral. Rev Med Suisse Romande. 1920;40:111–3.

    Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  14. Bell D, Jedynak D, Bell R. Predictors of outcome following endoscopic thoracic sympathectomy. ANZ J Surg. 2014;84(1–2):68–72.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  17. Licht PB, Ladegaard L, Pilegaard HK. Thoracoscopic sympathectomy for isolated facial blushing. Ann Thorac Surg. 2006;11:59–62.

    Google Scholar 

  18. Plas EG, Fugger R, Herbst F, et al. Complications of endoscopic thoracic sympathectomy. Surgery. 1995;118:493–5.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  20. Hutter J, Miller K, Moritz E. Chronic sequels after thoracoscopic procedures for benign diseases. Eur J Cardiothorac Surg. 2000;17:687–90.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    PubMed  PubMed Central  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  29. Ng CSH, Lau RWH, Wong RHL, et al. Evolving techniques of endoscopic thoracic sympathectomy: smaller incisions or less? Surgeon. 2013;11:290–1.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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. 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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Calvin S. H. Ng .

Editor information

Editors and Affiliations

Electronic Supplementary Material

Uniportal VATS pericardial window (WMV 26423 kb)

Vasoview uniportal sympathecotomy (WMV 12232 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chow, S.C.Y., Ng, C.S.H. (2019). Uniportal Approach to Pericardial Window and Sympathectomy. In: Gonzalez-Rivas, D., Ng, C., Rocco, G., D’Amico, T. (eds) Atlas of Uniportal Video Assisted Thoracic Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-13-2604-2_8

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-2604-2_8

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-2603-5

  • Online ISBN: 978-981-13-2604-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics