Graduated Clipping

In this technique, the titanium clip is applied to the sympathetic nerve in a graduated fashion. The clip is gradually closed until the adequate amount of force is applied to the nerve and the desired effect is obtained. The neural transmissions are slowed down but the nerve is not crushed. This graduated clipping of the nerve is a very precise maneuver that is thought to theoretically decrease the chance of adverse side effects (such as compensatory sweating). By not completely crushing the nerve, it is also thought that the reversal of this procedure is more likely to occur after the removal of the clip.