Twenty operations of video thoracoscopic sympathectomy (VTS) were performed on 17 patients in 1992-1994. The indications for the operation are Raynaud's disease and some obliterating occlusions of the upper limb arteries in which a reconstructive operation is not possible. The VTS operation is technically simple and atraumatic. Its effectiveness is determined by the disappearance of pain, warmer hands, and the results of histological study. The authors experience has shown that VTS does not need special instruments. At the same time, they believe that cooperation with specialists in thoracic and vascular surgery is very important and obligatory in development of complications.