Description

Thoracoscopic Sympathectomy is a highly specialized minimally invasive surgical procedure performed to manage conditions like hyperhidrosis (excessive sweating), Raynaud’s disease, and certain cases of refractory angina. At the World Laparoscopy Hospital, Dr. R. K. Mishra, a renowned laparoscopic and robotic surgeon, delivered an insightful lecture on this advanced procedure, highlighting both its clinical relevance and technical intricacies. Dr. Mishra began the lecture by explaining the anatomical basis of the sympathetic nervous system, focusing on the thoracic sympathetic chain and its role in regulating sweat glands and vascular tone. He emphasized how disruption of selected segments of this chain can dramatically improve patients’ quality of life when conservative therapies fail. Key Highlights of the Lecture Indications and Patient Selection Primary palmar, axillary, and plantar hyperhidrosis Severe cases of Raynaud’s phenomenon Selected patients with intractable angina or facial blushing Dr. Mishra stressed that careful patient evaluation and selection are critical to achieving long-term success. Surgical Technique The lecture detailed the step-by-step process of Thoracoscopic Sympathectomy, including: Patient positioning and anesthesia considerations Port placement and introduction of thoracoscope Identification of the sympathetic chain over the rib heads Precise resection, transection, or cauterization of targeted sympathetic ganglia (commonly T2–T4) Dr. Mishra demonstrated how modern thoracoscopic instruments enhance safety, precision, and recovery outcomes. Benefits of Minimally Invasive Approach Small incisions with minimal scarring Faster recovery and reduced hospital stay High success rate for symptom relief Improved patient satisfaction compared to open sympathectomy Challenges and Complications While thoracoscopic sympathectomy is generally safe, Dr. Mishra provided an honest discussion on potential complications, such as compensatory sweating, pneumothorax, or recurrence. He highlighted strategies to minimize these risks through meticulous surgical technique and appropriate case selection. Educational Value The lecture was not only a surgical demonstration but also an academic guide for surgeons in training. Dr. Mishra integrated real case experiences, surgical videos, and live discussions to enhance understanding among participants. Conclusion The Thoracoscopic Sympathectomy Lecture by Dr. R. K. Mishra provided an invaluable learning opportunity for young surgeons and gynecologists pursuing expertise in minimal access surgery. His ability to simplify complex anatomy and surgical steps while sharing practical tips made the session a comprehensive resource for advancing thoracic endoscopic surgery skills. World Laparoscopy Hospital continues to be a global hub for advanced surgical training, and lectures like these reinforce its commitment to combining innovation with surgical excellence.