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Thoracoscopic Sympathectomy for Primary Hyperhidrosis: A 3 mm Two-Port Approach.

Saman Qadri¹, Zummar Asad¹, Christina Schott¹

¹Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|December 30, 2025

Summary

This summary is machine-generated.

This study shows that a minimally invasive two-port video-assisted thoracoscopic sympathectomy (VATS) is a safe and effective outpatient surgery for primary hyperhidrosis. The procedure offers rapid recovery and significant symptom relief for patients with excessive sweating.

Keywords:

minimally invasive surgery primary hyperhidrosis sweating disorders thoracoscopic sympathectomy two-port technique video-assisted thoracic surgery

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Area of Science:

Thoracic Surgery
Dermatology
Minimally Invasive Procedures

Background:

Primary hyperhidrosis causes excessive focal sweating, impacting quality of life.
Surgical intervention offers a durable solution for patients unresponsive to medical treatments.
Video-assisted thoracoscopic sympathectomy (VATS) is an established surgical option.

Purpose of the Study:

To evaluate the efficacy and outcomes of a novel outpatient VATS sympathectomy technique.
To assess a two-port, 3-mm incision approach for VATS sympathectomy.
To determine the safety and patient-centeredness of this minimally invasive procedure.

Main Methods:

A case series of 33 consecutive patients undergoing outpatient VATS sympathectomy.
Procedures performed using a two-port, 3-mm incision technique at T3 and T4.
Evaluation of operative times, pain scores, recovery, and complication rates.

Main Results:

The technique demonstrated high efficacy with significant symptom reduction in palms, axillae, and soles.
Mean operative time was 22.0 ± 3.7 minutes, with all patients discharged same-day.
Low postoperative pain (2.0 ± 2.6) and complication rates comparable to conventional methods were observed.

Conclusions:

The two-port, 3-mm incision VATS sympathectomy is a safe and effective outpatient surgical approach.
This minimally invasive technique provides significant symptom relief for primary hyperhidrosis.
The procedure is patient-centered, supporting its wider adoption for hyperhidrosis treatment.