Uniportal Endoscopic Thoracic Sympathicotomy for Primary Hyperhidrosis.

Lee, Jung Kil; Kim, Jae Hyoo; Kwak, Hyoung Jun; Kim, In Young; Kim, Tae Sun; Jung, Shin; Kim, Soo Han; Kang, Sam Suk; Lee, Je Hyuk

Original Article

Journal of Korean Neurosurgical Society 2002;31(1): 16-20.

Jung Kil Lee, Jae Hyoo Kim, Hyoung Jun Kwak, In Young Kim, Tae Sun Kim, Shin Jung, Soo Han Kim, Sam Suk Kang, Je Hyuk Lee

Department of Neurosurgery, Chonnam National University Hospital and Medical School, Kwangju, Korea.

ABSTRACT

OBJECTIVE
Endoscopic thoracic sympathectomy is an effective procedure for primary hyperhidrosis. The author present a retrospective analysis of uniportal endoscopic thoracic sympathicotomy for primary hyperhidrosis.
METHODS
P Twenty patients underwent bilateral uniportal endoscopic sympathicotomy since August 1999. After collapsing the lung, a 6mm skin incision was made at the third intercostal space in anterior axillary line or just behind the posterior border of the pectoralis major and perforated with operating sheath. The endoscopy was 6.5mm in diameter and has one working channel(Karl Storz). An insulated 2mm coagulating forceps was introduced and T1-2 sympathicotomy with(13 patients) or without T2-3 sympathicotomy(7 patients) was performed. After the lung was fully inflated, the scope and the operating sheath were removed without chest tube, followed by single stitch.
RESULTS
Both sides were usually done within twenty minutes in a single stage. There was no postoperative complication except one case of pneumothorax and nineteen patients discharged at the following morning. Nineteen patients were satisfied with immediate and permanent relief of palmar perspiration. Recurrence of palmar hyperhidrosis has been noticed in one patient who underwent T1-2 sympathicotomy only, but the symptom was not so severe. There was no surgical mortality.
CONCLUSION
The results of endoscopic sympathicotomy in patients suffering from severe palmar and axillary hyperhidrosis are favorable. Single-port technique is enough for the successful sympathicotomy with less postoperative discomfort and scars.

Key Words: Endoscopy; Hyperhidrosis; Sympathectomy