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[Thoracoscopic Sympathectomy for Palmar and Axillary Hyperhidrosis]
Stephan Rohleder1, Oliver Münsterer1, Jan Gödeke1
1Klinik für Kinderchirurgie, Universitätsklinikum Mainz, Deutschland.
Zentralblatt Fur Chirurgie
|July 24, 2020
Summary
Thoracoscopic sympathectomy is a minimally invasive surgical treatment for hyperhidrosis (excessive sweating). This procedure effectively targets the sympathetic trunk and ganglia to provide long-term relief for patients suffering from palmar and axillary sweating.
Area of Science:
- Thoracic surgery
- Minimally invasive procedures
- Surgical anatomy
Background:
- Hyperhidrosis, characterized by excessive eccrine gland sweating, causes significant patient suffering, often worsening in adolescence.
- Focal hyperhidrosis affects specific areas like the face, armpits, hands, and feet.
- Thoracic sympathectomy is a globally recognized standard treatment for palmar and axillary hyperhidrosis.
Purpose of the Study:
- To provide a step-by-step description of the thoracoscopic sympathectomy procedure.
- To illustrate the technique for treating focal palmar and axillary hyperhidrosis.
Main Methods:
- The procedure is performed in a supine position with upper body elevation.
- Utilizes a 3mm trocar for a 30° optic and a 5mm trocar for bipolar forceps.
- Identifies and coagulates the sympathetic trunk and T2-4 ganglia over the rib heads.
Main Results:
- The thoracoscopic approach allows clear visualization of sympathetic structures.
- Direct vision enables selective ablation of the sympathetic trunk and ganglia.
Conclusions:
- Thoracoscopic sympathectomy offers a clear identification of target structures.
- Selective ablation under direct vision provides sustained long-term benefits for hyperhidrosis patients.
