The present study was designed to support the hypothesis that lumbar sympathectomy could be performed by minimal invasive surgery. In a porcine experiment, under laparoscopic vision control, a pneumoretroperitoneum was established through a direct retroperitoneal access for dissecting the retroperitoneal tissue layers and resecting the lumbar sympathetic trunc. The connective tissue septae were separated without any problems by blunt dissection under vision through the retroperitoneally inserted laparoscope. After exposure of the retroperitoneal organs and identification of specific landmarks, the resection of the lumbar sympathetic trunk was performed. We conclude that lumbar sympathectomy can be easily performed by minimal invasive surgery.