If conservative therapy does not work but the nerve blocks relieve pain even for a short period, then surgical sympathectomy can be considered. The videoscope surgical procedure performed to treat RSD is called thoracoscopic sympathectomy . The sympathetic chain is located and the thoracic segment of T2-T4 is cut of clipped. The incisions are sutured internally so that no sutures will need to be removed following the procedure. Some individuals want to go home the same day as surgery, and some spend the night and go home the next morning.
Patients are able to return to most normal activity within four to five days after surgery.
The only limitation is on heavy lifting for a week or two after surgery, which could cause pain. Patients are usually able to return to work within two to five days. Patients are sent home with pain medication that will be needed for a few days after surgery. Patients are able to shower two days after surgery. No surgery is without risk, but complications from this procedure are very rare.