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Article |

Endoscopic Procedures of the Upper-Thoracic Sympathetic Chain

Ming-Chien Kao, MD, DMSc
Arch Surg. 1995;130(11):1243-1244. doi:10.1001/archsurg.1995.01430110101020.
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I was pleased to have read the review article "Endoscopic Procedures of the Upper-Thoracic Sympathetic Chain" in the February 1993 issue of the Archives.1 The authors had extensively reviewed the endoscopic treatment of palmar hyperhidrosis; however, they did not mention my and my colleagues' advocated ideas and papers in their review.

As we know, the rapid development of endoscopic surgery since 1986 was mainly due to the introduction of the charge-coupled device video endoscopic system. That is the reason why original keyhole-vision endoscopic sympathectomy described by E. Kux in 1954 has little popularity.

In 1989, we first developed "video" endoscopic sympathectomy for palmar hyperhidrosis.2 With this technique, the operative field was well illuminated and magnified. The operator is liberated from the "peeping" posture in order to accommodate the endoscope for keyhole vision. Subsequently, the technique soon became popular and has replaced almost all traditional open sympathectomy.

Furthermore, we


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