March 1978

Thoracic Endoscopic Sympathectomy in Palmar and Axillary Hyperhidrosis

Author Affiliations

From the Department of Surgery, St Joseph Hospital, Vienna.

Arch Surg. 1978;113(3):264-266. doi:10.1001/archsurg.1978.01370150036005

• An endoscopic technique is described for thoracic sympathectomy. After establishement of a pneumothorax, the thoracoscope is introduced into the pleural cavity. The telescope is equipped with a wire electrode, a grasping forceps, and a suction coagulation probe for endoscopic electroresection of the sympathetic trunk. In 63 patients, 124 endoscopic sympathectomies were performed. All patients were relieved of sweating in the hands; 18.6% still had some perspiration of the axilla. Side effects of thoracic sympathectomy were compensatory and gustatory sweating that, in four patients, were more embarrassing than the original form of hyperhidrosis. Fifty-five patients were highly satisfied with the result of endoscopic sympathectomy, which is considered the appropriate minor procedure for the treatment of upper limb hyperhidrosis, causing minimal discomfort to the patient and almost invisible scars.

(Arch Surg 113:264-266, 1978)