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Ultra-Minimally Invasive Medical Thoracoscopic Sympathectomy for Primary Palmar Hyperhidrosis.

Zhengjun Li¹, Chang Liu¹, Tao Wang²

¹Department of Thoracic Surgery, Shenyang Chest Hospital, Shenyang, China.

Annals of Thoracic Surgery Short Reports

|June 10, 2026

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Endoscopic thoracic sympathectomy effectively treats palmar hyperhidrosis. A novel technique using medical thoracoscopy with nonintubation anesthesia improves safety and reduces invasiveness for this hyperhidrosis treatment.

Area of Science:

Thoracic Surgery
Minimally Invasive Procedures
Anesthesiology

Background:

Primary palmar hyperhidrosis is a condition causing excessive sweating in the hands.
Endoscopic thoracic sympathectomy (ETS) is a common surgical treatment for palmar hyperhidrosis.
Current single-port thoracoscopy techniques face challenges like instrument collisions and tissue damage.

Purpose of the Study:

To introduce a simple, minimally invasive surgical technique for ETS.
To overcome the limitations of current single-port thoracoscopy in ETS.
To enhance safety, reduce tissue damage, and improve cosmetic outcomes in ETS.

Main Methods:

Utilized medical thoracoscopy combined with nonintubation anesthesia.
Incorporated perfusion index monitoring during the procedure.

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Developed a technique to prevent telescope and endodissector collisions in single-port surgery.

Main Results:

The described technique offers a simple and minimally invasive approach to ETS.
It effectively addresses instrument collision issues inherent in single-port thoracoscopy.
The method aims to improve safety, reduce tissue damage, and enhance aesthetic results.

Conclusions:

This modified medical thoracoscopy technique provides a safe and effective alternative for treating palmar hyperhidrosis.
The approach minimizes surgical obstacles and enhances patient outcomes.
Further research should explore the long-term efficacy and broader application of this technique.