Definitive treatment of hyperhidrosis with Toracoendoscópica Surgery

Written by: Dr.Prof. Alfredo Moreno Egea
Edited by: Top Doctors®

Hyperhidrosis is excessive sweating of certain body parts. The recommended treatment is Thoracoscopic sympathectomy, a surgery that disrupts the nerves that transmit signals to the sweat glands.


Hyperhidrosis: what is

Hyperhidrosis is excessive sweating of hands, armpits and feet that greatly affects the quality of life of people, especially his social relationship, preventing them from leading a normal life. Experts say in general surgery , it affects more than 3% of the general population and has a hereditary component. Its origin is not known with certainty but there is an abnormally high level of sympathetic stimulation chest.


Adverse effects of hyperhidrosis in the patient's life

Hyperhidrosis causes emotional stress, hindering social personal, work and patient, creating a vicious circle for the need to feel "dry" and concern stink. People suffering hyperhidrosis become more withdrawn and shy away from social activity, avoiding situations where contact with other needs, being able to create a social phobia. The disease also hampers the use of paper, pencils, buttons, tools, electronic equipment or musical instruments. Finally, there is the need to avoid the handshake leading patients to seek a definitive solution.


Diagnosis of hyperhidrosis

The diagnosis is clinical and does not require complex or expensive studies. It is advisable to correct history to exclude thyroid problems or other associated diseases.The diagnostic criteria for primary hyperhidrosis are:1) Local and visible hyperperspiration, more than 6 months without secondary cause known2) At least two of the following features:or bilateral and symmetricalor at least a weekly episodeor interference with normal daily activityor onset before age 25or family historyor Not sweating during sleep


Treatment of Hyperhidrosis and innovative techniques

People with hyperhidrosis or excessive sweating, regardless of temperature and emotional state, they can not control, should be operated, and that the disease can also cause fungi, peeling, odor, irritation and skin pigmentation. Therefore, the operation should be considered in all patients with hyperhidrosis of long evolution that have found no improvement with medical treatment.

Currently there are innovative techniques for the treatment of hyperhidrosis. Formerly a very aggressive operation and needed "open chest". However, today, the Thoracoscopic sympathectomy is an operation that is performed using modern minimally invasive surgical techniques. Usually the preparation prior to surgery is simple and requires only a few laboratory tests and consultation with the anesthesiologist, to proceed to schedule the procedure safely.

Thoracoscopic sympathectomy with the interruption of the nerves that carry signals to the sweat glands is achieved. Thus, the sympathetic chain in the back of the chest is located and stopped by ultrasonic scalpel. To carry out two small incisions of 5 mm are used, through which a small lens which is connected to a video camera, and some very fine instruments (forceps) designed for this type of operation is entered.

The operation is performed under general anesthesia and usually requires entry of an evening (24h), ie, the patient goes home the next morning of the operation. Patients can return to normal activities 3-4 days after surgery.


Results of treatment of hyperhidrosis

Thoracoscopic sympathectomy is the treatment of choice for excessive sweating of the hands, with an immediate, permanent and definitive result in 95% of patients.


Hyperhidrosis treatment risks

Thoracoscopic sympathectomy has almost no consideration risks. The most common side effect is compensatory sweating, which is an increase of sweating in the chest, abdomen and thighs, as a compensation mechanism for the decreased sweating in the hands and armpits (the body diverts stimulus sweating out undisturbed areas). This effect has been reported in a significant number of patients and is usually mild and less annoying than the initial symptoms of sweating hands and armpits. However, I can be severe in 8% of cases. Therefore, the patient must be well informed, analyzing the benefits provided surgery and warning of the risk of this compensatory sweating.Another adverse effect described and rare presentation is called Horner syndrome, the most obvious manifestation is a slight drooping of the upper eyelid on the affected side, which usually resolves with time. This complication is very rare and seldom permanent.Other potential risks are common when having surgery: bleeding, infection, pneumothorax, pleural effusion, among others.


*Translated with Google translator. We apologize for any imperfection

By Dr.Prof. Alfredo Moreno Egea

Dr. Alfredo Moreno Egea is Doctor "Cum Laude" in Medicine and Surgery, Academic Correspondent and Professor of Surgery. Has over 25 years experience in the specialty, being instructor Laparoscopic Surgery for other novice surgeons and residents, Wall Unit Coordinator Abdominal Hernia Diploma from the University of Monterrey, and Secretary General of the Spanish-American Hernia Society. He has published more than 200 scientific articles in prestigious journals, both national and international (as first author), has participated in numerous conferences and meetings as an expert, it belongs to the Editorial Board of numerous journals and is a regular speaker at conferences specialty. He is currently Head of the Hernia Clinic referral center for troubleshooting the abdominal wall (Hernia) of abdominal contouring (tummy tucks) and treat post-surgical inguinal nerve pain (neurectomy), among other conditions.

*Translated with Google translator. We apologize for any imperfection

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