Single-port vasoview sympathectomy for palmar hyperhidrosis: a clinical update

Thoracic sympathectomy remains an effective method for treatment of palmar hyperhidrosis refractory to other conservative forms of management. The procedure has become more acceptable following the introduction of the minimally invasive technique using video-assisted thoracic surgery (VATS). More recently, single-port VATS has gained popularity as an alternative approach to performing sympathectomy. We report on our experience and early results of single-port bilateral VATS sympathectomy using the Vasoview(®) (Maquet Inc., Rastatt, Germany) device at our institute.

All patients who underwent VATS sympathectomy for primary palmar hyperhidrosis between June 2011 and March 2012 were recruited into this prospective study. Patients' demographics and intraoperative and postoperative outcomes were collected. Effectiveness of the procedure, postoperative pain, duration of hospital stay, and complications were also measured.

Sixteen patients underwent Vasoview bilateral VATS sympathectomy for severe palmar hyperhidrosis. Mean age was 23.8 years (range, 17-36 years), and mean operative time to complete the bilateral procedure was 56 minutes (range, 42-81 minutes). The procedure was successfully completed in all patients without the need to enlarge the incision or convert. Postoperatively, there was no mortality and no residual palmar hyperhidrosis. Mean postoperative stay was 0.9 days (range, 0.7-1.9 days). The mean visual analog pain score at discharge was 1.8 (range, 1.2-3.4).

Single-port Vasoview sympathectomy for treatment of severe palmar hyperhidrosis is technically feasible and safe with satisfactory immediate and early results. Intermediate and long-term follow-up is required to monitor recurrence or late complications. Future studies are warranted to compare Vasoview single-port and other minimal invasive VATS approaches.