Cervicodorsal sympathectomy is indicated for Raynaud’s disease, Buerger’s disease of upper limb, Syringomyelia. The sympathetic chain is identified crossing neck of ribs—stellate ganglia on first rib. The stellate ganglia are not removing, but 2nd and 3rd ganglia are removed. Lumber sympathectomy is indicated for Buerger’s disease, hyperhidrosis. The L2, L3, L4 ganglia with white and grey rami are excised through extra peritoneal approach.by a transverse or oblique incision starting midway between anterior superior iliac spine and costal margin to lateral border of the rectus.