Mini-invasive endoscopic surgery

1.As active surgeon can be claimed when the trainee has actively participated in all phases of treatment, has made or confirmed the diagnosis, participated in the selection of the appropriate procedure. has either performed or been involved in performing the procedure and has been a responsible participant in both pre- and postoperative care.

1.Sympathectomy is preferable to amputation in following criteria are met : ABI greater than 0.3, absent neuropathy, limited soft tissue loss. Patients selection is important one to prevent failure of procedure.

1.Contraindications for thoracic/lumbar sympathectomy are rapidly progressing ischemic lesions and poor general condition of the patient. Indications are: superficial skin ulcer, causalgia, vasospastic disorders- frostbite and Raynaud's disease, hyperhidrosis, inoperable arterial occlusive disease with ischemia causing rest pain, a consequence of atherosclerosis, vasculitis, thoracic outlet syndrome, and Buerger's disease, trauma related conditions.