Needlescopic thoracic sympathectomy: Treatment for palmar hyperhidrosis

Background. Open thoracic sympathectomy has been the established option for patients with essential hyperhidrosis. Recently, video-assisted endoscopic sympathectomy has provided a simple, safe, reliable, and cost-effective al ternative to the earlier technique. With advances in instrumentation, perfo rming the procedure through 2-mm and 3-mm needlescopic ports is now possibl e. The authors evaluate the effectiveness of so-called needlescopic thoraci c sympathectomy for the treatment of primary hyperhidrosis. Methods. Thirty five consecutive patients with a mean age of 24 years, incl uding 23 men and 12 women, underwent bilateral needlescopic thoracic sympat hectomies at the National University Hospital of Singapore. Results. The mean operative duration was 56 minutes, and the mean hospital stay was 1.2 days. In no patient did Horner's syndrome or significant pneum othorax develop. The rate of success, defined as completely dry hands, was 97%. Two patients had unilateral recurrences that responded well to repeat needlescopic sympathectomies. We performed a total of 72 sympathectomies. Conclusions. Our study demonstrates that the use of miniature port access s ites produces excellent medical and cosmetic results and is associated with a short hospital stay and low risk of complications. (Ann Thorac Surg 2000 ;70:240-2) (C) 2000 by The Society of Thoracic Surgeons.