Can a Thoracic Sympathectomy and a Lumbar Sympathectomy be Done at the Same Time?

So far these two procedures have never been done at the same time. There are a few reasons for this.

1. We do not have the ability to judge the response of the sympathetic system when two locations (thoracic and lumbar) have been at the same time. We do not have any way to ascertain the body’s potential reaction.
2. The Lumbar sympathectomy is a longer and more demanding procedure. Dr. Reisfeld believes the procedures should be done separately.
3. We have very limited clinical experience in doing both a lumbar sympathectomy and a thoracic sympathectomy at the same time. In these cases, a one side thoracic sympathectomy and a lumbar sympathectomy are done on the same day. The other side is done at a later date. The results were positive, but the final clinical recommendation at this point is to not perform both procedures at the same time because we still have some unanswered physiological questions. We need to know how blood pressure and the sympathetic system are affected.
4. A general rule in surgery states that no two elective operations on different parts of the body should be performed at the same time. This rule is based on pure logical considerations and most importantly, patient safety.
5. Until we understand the effects and reactions of the body to these procedures, the surgeries should be separate. If new evidence arises showing a positive reaction to the procedures, it is possible that both could be done at the same time in the future.