RT Book, Section A1 Davenport, Katherine P. A1 Kane, Timothy D. A2 Ziegler, Moritz M. A2 Azizkhan, Richard G. A2 Allmen, Daniel von A2 Weber, Thomas R. SR Print(0) ID 1100433680 T1 Thoracoscopy for Sympathectomy and Spine Exposure T2 Operative Pediatric Surgery, 2e YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 978-0-07-162723-8 LK accesspediatrics.mhmedical.com/content.aspx?aid=1100433680 RD 2024/10/14 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.