Dorsal Sympathectomy is a surgical procedure that involves removing part of the dorsal sympathetic nerves (part of the autonomic nervous system), which surround the spinal cord within the upper part of the back. The procedure involves dorsal sympathetic nerves, which are responsible for the contraction and expansion of small arteries within the arms, lungs, and upper ribs.

What are the reasons for a dorsal sympathectomy procedure?

• Restoring normal supply of blood to the arms
• Removing part of the sympathetic nerve that causes spasms within the blood vessels
• To treat excessive sweating

How a dorsal sympathectomy procedure is performed?

• After inserting a tube in the airway to aid breathing, an incision is made below the armpit (chest region)
• The lung on the side of surgery is allowed to deflate (to help get space for the operation)
• A tube fitted with a camera (a special instrument called a thoracoscope) is inserted into the chest. Additional small incisions are made through which surgical instruments are introduced
• The appropriate nerves are identified and cut (which turns of sweating)
• The surgical instruments are removed after the lung is re-expanded
• A temporary tube (plastic drain) may be left in place for some time to help remove any air or fluid in the chest
• The incisions are sutured

The Dorsal Sympathectomy procedure is performed by a general surgeon, neurosurgeon or vascular surgeon. It may take a few hours to complete the procedure.

Preparation needed before a dorsal sympathectomy procedure

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
• Some medications increase a person’s chances of bleeding, and it may be recommended to discontinue them for a period of time before the procedure is performed
• Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
• Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
• Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
• It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
• Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not, their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines

Complications during dorsal sympathectomy surgical procedure

• Excessive bleeding
• Infection within the surgical wound
• Anaesthetic complications
• Accidental injury to lung tissue
• Lung collapse

Complications after dorsal sympathectomy surgical procedure

• Excessive bleeding
• Infection within surgical wound
• Lung collapse

Post-operative care after dorsal sympathectomy surgical procedure

• Slowly resume daily activities as early as possible, which aids in faster recovery
• Women may be required to use sanitary napkins (for bleeding) for about a week or more
• Use a heat pad or warm compress to relieve pain due to the incision
• Resume showering and keep the wound clean and dry. Gently wash the surgical wound with a mild, unscented soap
• Elevate legs while resting to prevent the formation of blood clots and reduce the possibility of swelling
• Complete the course of prescribed medication as advised by your physician
• Take stool softeners to prevent constipation, under advice of the physician
• Take antibiotic medication to help combat or prevent infection, under advice of the physician
• Avoid taking non-prescription medications such as aspirin. However, individuals may take acetaminophen to relieve pain
• Avoid all activities that are physically strenuous for about 6 weeks after surgery
• Resume driving only after 2 weeks of being discharged from the hospital, or when advised by the physician
• Avoid sex till complete healing has taken place (under advise by the physician)
• Individuals are advised to have to clear liquids immediately after surgery, until the gastrointestinal tract begins properly functioning. Then proceed to eat a well-balanced diet, which can aid in a faster recovery. After a complete recover has occurred, maintain a low-fat, low-salt diet