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History of sympathetic surgery
1Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. hasmonai@inter.net.il
Summary
Sympathectomy, an operation on the sympathetic nervous system, has evolved significantly since 1889. Today, it primarily treats hyperhidrosis and blushing, with ongoing research into its techniques and side effects.
Area of Science:
- Neurology
- Surgical Innovation
Background:
- The upper sympathetic system has been surgically targeted since 1889.
- Initial indications for sympathectomy, such as epilepsy and glaucoma, are now obsolete.
Observation:
- Current primary indications for sympathectomy include hyperhidrosis and blushing.
- Surgical techniques have evolved from open resections to less invasive endoscopic methods like thermoablation and clipping.
- Renewed interest exists in applying sympathectomy for psychological conditions.
Findings:
- Compensatory hyperhidrosis remains a significant sequela for a small patient subset.
- Reversal techniques, including nerve grafting and unclipping, have been developed to address sequelae.
Implications:
- Further meticulous follow-up studies are essential to validate new sympathectomy techniques.
- Enhanced understanding of autonomic nervous system function is crucial for mitigating and treating surgical sequelae.