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Thoracoscopic sympathectomy: techniques and outcomes.

J P Johnson¹, S S Ahn, W C Choi

¹Divisions of Neurosurgery and Vascular Surgery, Department of Surgery, School of Medicine, University of California, Los Angeles, Los Angeles, California; and Department of Neurological Surgery, Montreal Neurological Institute, Montreal, Quebec, Canada.

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Summary

Minimally invasive thoracoscopic sympathectomy offers reduced morbidity and hospital stays for palmar hyperhidrosis and pain disorders. Outcomes are equivalent to open surgery, with high patient satisfaction, making it a viable treatment option.

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Area of Science:

Thoracic Surgery
Minimally Invasive Procedures

Background:

Thoracic sympathectomy is a treatment for palmar hyperhidrosis and pain disorders.
Traditional open procedures had limitations including invasiveness and morbidity.
Limited outcome studies existed for thoracoscopic sympathectomy.

Purpose of the Study:

To evaluate the outcomes and safety of thoracoscopic sympathectomy.
To compare thoracoscopic sympathectomy with traditional open surgical techniques.

Main Methods:

Performed 60 thoracoscopic sympathectomy procedures on 39 patients.
Assessed outcomes, morbidity, hospital stay, return to normal activity, complications, and recurrence.

Main Results:

Outcomes were equivalent to established open surgical techniques.
Operative morbidity, hospital stay, and return to normal activity were substantially reduced.
Complications and recurrence rates were comparable to previous reports, with high patient satisfaction (66-96%).

Conclusions:

Thoracoscopic sympathectomy is a safe and effective minimally invasive option.
It offers reduced morbidity and equivalent outcomes compared to open surgery for sympathetically mediated disorders.
Patients and physicians can consider this procedure due to its favorable risk-benefit profile.