First and foremost any surgeon who attempts to perform lumbar sympathectomy should be very well versed with the anatomy and the technique of how to do the procedure. Any surgeon should be proctored by an experienced surgeon who has done enough procedures (ELS). The reason for this extra caution is the fact that the lumbar sympathetic chain runs very close to major blood vessels, ureter and other nerves that run very close to it. This part particular area of the body is not very familiar to many surgeons. For this reasons many surgeons are not comfortable performing surgeries there.
The side effects such as pain and discomfort are described to be less than thoracic sympathectomy. It is also known that performing lumbar sympathectomy (ELS) below lumbar vertebra L-2 will not cause retrograde ejaculation. Inner thighs compensatory sweating or buttock compensatory sweating which are the results of the thoracic sympathectomy can be lessened with lumbar sympathectomy. Any patient who had the previous retro peritoneal surgery is almost excluded from having this surgery. Statistically more females will choose this operation because of the inability to wear certain types of shoes (high heels, sandals etc.)