ABSTRACT
Dorsal sympathectomies have been performed since the beginning of the twentieth century, with the earliest reported by Alexander in 1889. The initial video-assisted thoracoscopic surgery (VATS) sympathectomy, performed in 1978, demonstrated a less invasive and effective method to operate safely within the thoracic cavity. Although not life threatening, hyperhidrosis can be psychologically traumatic and socially disabling for the individual. For those patients undergoing sympathectomy for hyperhidrosis, most are very satisfied with their immediate results. The reported success of the procedure ranges from 85" to 98" for palmar hyperhidrosis but is only about 70" for axillary hyperhidrosis. By using minimally invasive methods and bilateral intercostal nerve blocks, and there being a lack of intrapleural drainage, the procedure may be performed in an ambulatory setting with patients being discharged home on the same day and experiencing immediate relief of their embarrassing social problem.
