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The History of Sympathetic Surgery.

Moshe Hashmonai¹

¹Department of Surgery, Rambam Medical Center & Faculty of Medicine, Technion - Israel Institute of Technology, PO Box 359, Zikhron Ya'akov, Haifa 3095202, Israel.

Thoracic Surgery Clinics

|October 4, 2016

Summary

Primary hyperhidrosis is treated with sympathectomy. The ideal surgical approach for upper thoracic sympathetic ablation to manage facial and upper limb sweating requires further research, including controlled studies.

Keywords:

History Hyperhidrosis Sympathetic anatomy Sympathetic physiology Sympathetic surgery

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Area of Science:

Neurosurgery
Thoracic Surgery
Dermatology

Background:

Primary hyperhidrosis is a common indication for surgical sympathectomy.
Historically, open surgery involved excising thoracic ganglia for upper limb and facial sweating.
Thoracoscopic techniques have evolved, modifying ablation levels and extent to reduce side effects.

Observation:

The optimal surgical strategy for sympathectomy in primary hyperhidrosis remains undefined.
Current thoracoscopic approaches aim to improve outcomes and minimize compensatory sweating.
There is a need for standardized, quantitative assessments of sweat production.

Findings:

The standard for open sympathectomy involved specific thoracic ganglion excisions.
Thoracoscopic sympathectomy offers modifications to the ablation strategy.
The ideal procedure for denervation of the face and upper limbs is yet to be established.

Implications:

Further research is needed to define the best surgical technique for sympathectomy.
Controlled, double-blind studies are essential for quantitative sweat measurement.
Optimizing sympathectomy techniques can improve quality of life for hyperhidrosis patients.