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Robotic-assisted reversal of thoracic sympathectomy with nerve grafting represents a novel and technically demanding procedure aimed at restoring sympathetic function in patients experiencing adverse outcomes after sympathectomy, such as compensatory hyperhidrosis or dysautonomia. This chapter reviews the indications, preoperative planning, surgical technique, and outcomes of robotic sympathectomy reversal. The enhanced visualization, precision, and instrument dexterity afforded by robotic platforms make them well-suited for the meticulous dissection and microsuturing required for nerve graft anastomosis to the sympathetic chain. We describe patient selection criteria, intraoperative considerations, and postoperative recovery protocols, along with illustrative case examples and early clinical experiences. As experience with this approach grows, robotic sympathectomy reversal may become an important option in the armamentarium of nerve reconstruction surgery.

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The Use of Robotic Platforms for the Reversal of Thoracic Sympathectomy

  • 章节

  • 发表日期：

    2025年

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  • Allen Wei-Jiat Wong,
  • Lisa Wen-Yu Chen,
  • Yin-Kai Chao,
  • Chuan Cheng,
  • Chin-Pang Lee,
  • Kuo-Hsuan Chang,
  • Amina Illias,
  • Cheyenne Wei-Hsuan Sung,
  • Dong-Yi Chen,
  • Tommy Nai-Jen Chang

摘要

Robotic-assisted reversal of thoracic sympathectomy with nerve grafting represents a novel and technically demanding procedure aimed at restoring sympathetic function in patients experiencing adverse outcomes after sympathectomy, such as compensatory hyperhidrosis or dysautonomia. This chapter reviews the indications, preoperative planning, surgical technique, and outcomes of robotic sympathectomy reversal. The enhanced visualization, precision, and instrument dexterity afforded by robotic platforms make them well-suited for the meticulous dissection and microsuturing required for nerve graft anastomosis to the sympathetic chain. We describe patient selection criteria, intraoperative considerations, and postoperative recovery protocols, along with illustrative case examples and early clinical experiences. As experience with this approach grows, robotic sympathectomy reversal may become an important option in the armamentarium of nerve reconstruction surgery.