Endoscopic Trans-thoracic sympathectomy in the treatment of primary palmar hyperhidrosis: results and complications

ABSTRACT

This study aimed to evaluate the results of primary palmer hyperhidrosis by using endoscope transthoracic sympathectomy with particular reference to the complication, the immediate and long term effectiveness of treatment and patient satisfaction with the endoscope results. Twenty patients with bilateral primary hyperhidrosis were treated by endoscopic transthoracic sympathectomy on both sides. When the stellate ganglion is uniquely identified by a pad of fat covering it above the head of the first rib, a diathermy hook used to confirm identification by palpating the sympathetic chain and rolling the nerves over the ribs. The 2nd, 3rd and 4th ganglia were cut and preserved for histopathological examination. All patients were relieved of their symptoms except the left side of a female patient [aged 26 years and treated by open surgical method]. Compensatory hyperhidrosis was the only significant side effect and reported in sixty five%. There was no mortality or major complications. Endoscopic transthoracic sympathectomy is safe-easy, reliable and effective way in the treatment of patients with primary palmer hyperhidrosis