[Upper thoracic sympathectomy by thoracoscopic approach. A method of choice for the treatment of palmar hyperhidrosis].

Palmar hyperhidrosis is excessive sweating beyond physiological needs in the palm without recognized etiology. Although a benign disease, it is annoying to most patients. Currently the best treatment for this condition is upper thoracic sympathectomy via many different approaches. The video-thoracoscopic approach has been recommended a a minimally invasive procedure. We report our 1-year experience with transaxillary endoscopic sympathectomy in 99 patients with palmar hyperhidrosis. Standard video-laparoscopy was used via a transaxillary approach to perform sympathectomy. The mean operating time of this operation was 12 minutes and mean hospital stay was 32 hours. The results in terms of warm and dry hands were excellent. Only one case of transitory Horner syndrome was noted. Transaxillary thoracoscopic sympathectomy for palmar hyperhidrosis is a relatively simple and effective procedure which can be performed with standard laparoscopic instruments. The advantages are, short recovery time and hospital stay along with excellent functional and cosmetic results. We are convinced that thoracoscopic sympathectomy is the procedure of choice for the treatment of palmar hyperhidrosis.