Thoracoscopic sympathicotomy for hyperhidrosis--surgical technique, complications and side effects.

Thoracic sympathectomy is a very effective treatment of palmar hyperhidrosis. The described endoscopic technique has given good primary results in 99% of patients. After another session with this type of "minimal invasive surgery" 100% of the hands were satisfactorily dry. The hospital stay is just one post-operative day and the sick-leave is about a week. The drawbacks are minimal. Pain is tolerable and only eight patients needed a post-operative Bülau-drainage because of pneumothorax or bleeding. About 50% of patients experience a compensatory increased sweating of the trunk, but this is related to a warm environment and regulation of body temperature and seems to decrease with time. This technique makes it possible to treat all those suffering from palmar hyperhidrosis which can be a substantial, but underestimated handicap. To meet this kind of patient after a successful operation is extremely satisfying even for the surgeon. The post-operative wet and cold hand has immediately post-operatively become warm and dry.