Video thoracoscopic splanchnicectomy in persistent epigastric pain

: For palliation of persisting pain caused by inoperable malignity in the epigastrium or chronic pancreatitis a number of surgical and non-surgical operations of the splanchnic nerves was elaborated. Abdominal and thoracic approaches are associated with technical difficulties and burden the patient; blocks by puncture are associated with risk. The optimal procedure appears to be videothoracoscopic left-sided splanchnicectomy, the authors performed this operation in nine patients (in seven on account of a malignant process, in two on account of chronic pancreatitis). In all immediate alleviation of pain occurred, in two later some pain reappeared. Based on the favourable experience, the authors recommend this minimal invasive procedure.