Endoscopic transthoracic sympathectomy with a fine (2-mm) thoracoscope in palmar hyperhidrosis: a case report

Endoscopic transthoracic sympathectomy (ETS) is a minimally invasive method, causing only small injuries and few complications, and requires only a short period of hospitalization. Therefore, this method has been applied to patients with palmar hyperhidrosis to whom the conventional transthoracic sympathectomy, which is much more invasive, or thoracic sympathetic blockade, which often causes complications, cannot be applied. Conventional thoracoscopes, such as a resectoscope 8 mm in diameter for urological operations, or a thoracoscope 5 mm in diameter, were usually used for this purpose, but they cause operative injuries. We performed ETS using a thoracoscope 2 mm in diameter (MiniSite 2 mm 0 degrees, USSC171303). Its visual field and handling were not inferior to those of conventional thoracoscopes, and the operative injuries were only 2 mm in size. For the patient, a small scar of this size means virtually no scar.