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June 19, 1954


JAMA. 1954;155(8):768. doi:10.1001/jama.1954.03690260060018

Lumbar Sympathectomy.  —At a meeting of the Associação Paulista de Medicina, Drs. Edmundo Vasconcellos and Faud Al Assal reported 72 extraperitoneal lumbar sympathectomies, of which 10 were bilateral. All were performed by a new technique devised by the authors. A rectilinear incision of the skin and the subcutaneous cellular tissue from the extremity of the 12th rib to a point two fingerbreadths inside the anterior superior iliac spine is made. The perimysium and a small part of the obliquus internus abdominis muscle are incised close to the costal arch. Divulsion of the transversus abdominis muscle and the fascia transversalis is accomplished. The peritoneum is dissected with a dull probe to expose the psoas minor muscle and its arcades of insertion on the anterior aspect of the lumbar spine. The peritoneum is loosened upward, and the kidney and the ureter are moved to the side to expose the diaphragmatic pillar. The

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