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Updated: May 27, 2026
03:59
Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
Published on: January 10, 2019
Sympathetic chain clipping for hyperhidrosis is not a reversible procedure.
Jesus Loscertales1, Miguel Congregado, Rafael Jimenez-Merchan
1Department of General and Thoracic Surgery, Virgen Macarena University Hospital, Ave. Dr. Fedriani, 3, 41074, Seville, Spain.
Surgical Endoscopy
|November 16, 2011
Summary
Clipping for palmar hyperhidrosis causes nerve damage and axon loss. Even after clip removal, nerve regeneration does not occur, indicating this method is not reversible.
Area of Science:
- Neurosurgery
- Regenerative Medicine
- Surgical Innovation
Background:
- Palmar hyperhidrosis treatments often cause compensatory sweating.
- Clipping of the sympathetic chain was proposed as a reversible treatment.
- Investigating the nerve lesion and regeneration potential after clipping is crucial.
Purpose of the Study:
- To investigate the neuronal lesion of the sympathetic chain caused by clipping.
- To assess the possibility of nerve regeneration after clip removal.
Main Methods:
- Experimental study using a swine model.
- Clipping, unclipping, and extirpation of sympathetic chain segments.
- Pathological and statistical analysis at 10, 20, and 30 days post-procedure.
Main Results:
- Wallerian degeneration observed within 10 days of clipping.
- Extensive degeneration of myelinated fibers by 20 days.
- Significant macrophagic reaction and myelin debris phagocytosis by 30 days; minimal residual fibers after clip removal.
Conclusions:
- Clipping causes significant Wallerian degeneration and axon loss.
- Absence of myelinated and amyelinated fibers post-removal indicates no nerve regeneration.
- Clipping is not a reversible technique for palmar hyperhidrosis treatment.
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