Intercostal Nerve Reconstruction for Severe Compensatory Hyperhidrosis: The Gebitekin Technique

Compensatory sweating (CS) is the most common and disabling complication of endoscopic thoracic sympathectomy and represents an unmet clinical challenge. Our surgical hypothesis is to generate a parallel pathway to the damaged part of the sympathetic nerve, similar to the Kuntz nerve, by reconstructing the 2 healthy intercostal nerves, thus treating CS. Here, we present a novel videothoracoscopic technique involving bilateral intercostal nerve reconstruction in patients with severe CS after endoscopic thoracic sympathectomy.