TY - CHAP M1 - Book, Section TI - Thoracoscopy for Sympathectomy and Spine Exposure A1 - Davenport, Katherine P. A1 - Kane, Timothy D. A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. Y1 - 2014 N1 - T2 - Operative Pediatric Surgery, 2e AB - For thoracoscopic sympathectomy for primary hyperhidrosis and thoracoscopic spine exposure for release of thoracic scoliosis, video-assisted thoracoscopic surgery (VATS) offers several advantages, including shorter hospital stay for patients and lower morbidity.Surgical treatment is recommended for severe cases of primary hyperhidrosis or those refractory to medical management. Upper thoracic sympathectomy interrupts transmission of impulses from the sympathetic ganglia to the sweat glands and can offer immediate and permanent relief.Compensatory sweating (CS) occurring in the back, chest, and thighs is the most common side effect of thoracoscopic sympathectomy, but the reported incidence and severity are lower than in adults and very few adolescent patients express regret for having undergone thoracoscopic sympathectomy.The initial access for thoracoscopic spine exposure should be just above the level of the central-most portion of the proposed release.At each level, the intervertebral space is entered by using electrocautery to incise the pleura and overlying fascia between the segmental vessels superior and inferior to the line of incision and standard curets and other extraction devices are used to remove the disk.When all the selected disks have been removed, the bone graft that has been harvested from the iliac crest and morcellated can be packed into each intervertebral space. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/14 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1100433680 ER -