Abstract
Hyperhidrosis of the palms and axillae has a strong negative impact on the patients social and professional life. The existing non-operative therapeutic options seldom give sufficient relief, and its effects are usually transient. Surgical sympathectomies have been performed to treat the palmar hyperhidrosis.
This letter describes the video assisted thoracoscopic technique for bilateral sympathectomy. We also report some technical improvements.
Between August 1995 and September 1997, we performed 17 video assisted thoracoscopic sympathectomies for the treatment of palmar hyperhidrosis. We performed bilateral sympathectomy by removing the T2 and T3 sympathetic ganglions. The patient was placed in the semi-Fowler's position under general anesthesia. Sympathectomies on both sides were performed without changing the patient's position. Immediate and dramatic decrease in the sweat excretion in the palms was noted in all patients. Fifteen patients were highly satisfied with the results. The commonest side effects were compensatory sweating (11/17, 65%). In two patients, this was more embarrassing than the original form of hyperhidrosis. Postoperative Horner's syndrome was not observed. Video assisted thoracoscopic sympathectomy is a minimally invasive procedure for the palmar hyperhidrosis, but enough effective, safe and reliable. This procedure is strongly recommended for the patients they need surgical treatments of upper limb hyperhidrosis.
