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What is Hyperhidrosis?

Hyperhidrosis is the medical term for excessive sweating. Sweating is the body's way of cooling itself. In the case of palmar hyperhidrosis, the sweating of the hands is excessive. People with this condition suffer terrible embarrassment from their constantly "wet" hands. These individuals cannot hold glasses of liquid safely, hold objects without getting them "wet," hold hands or shake hands comfortably.

What causes hyperhidrosis?

Hyperhidrosis is not a disease, but a symptom. Physicians do not know exactly what causes hyperhidrosis but they have linked it to over activity of the nerves that send signals to the sweat glands in the skin. The chain of the sympathetic nervous system that controls perspiration is known as apocrine and eccrine glands. If other causes such as hyperthyroidism, obesity, psychiatric causes have been eliminated, then primary hyperhidrosis can be diagnosed. Medical therapy is available, but most therapies are inconvenient, unsuccessful or cause a variety of side effects that are not beneficial to the cure.

 What surgical treatment is available?

The videoscope surgical procedure performed to treat hyperhidrosis is called Thoracoscopic Sympathectomy. Since this condition affects both hands, a bilateral (both sides) sympathectomy is done. The procedure is performed using a thoracoscope-a tiny camera that transmits images from inside the chest to a video monitor. The video camera and instruments are inserted through 2-3 small incisions located in the side of your chest under the axilla (armpit). The sympathetic chain is located and the thoracic segment responsible for sweating is cut or clipped. The incisions are sutured internally (no sutures will need to be removed). The process is repeated on the other side.

How long is recovery from surgery?

Some individuals want to go home the same day as surgery; some spend the night and go home the next morning. You will be able to return to most normal activity within 4-5 days after surgery. The only limitation will be heavy lifting for a week or two after surgery, which could cause pain. You will be able to return to work within 2-5 days. You will be sent home with pain medication that you will need for a few days after surgery. You will be able to shower 2 days after surgery.

What is the success rate of this surgery?

There is over a 95% success rate with this surgery of having dry hands immediately after surgery.

What complications may arise from this surgery?

No surgery is without risk, but they are very rare in this procedure. Bleeding, pneumothorax and infection are a few. Horner's syndrome in which there is drooping of the upper eyelid, permanent constriction of the pupil, or no facial sweating on the same side of the surgery are symptoms associated with this condition. This is rare as well.

What side effects may occur from this surgery?

Some individuals have a delayed episode of sweating for 1-2 hours to half a day a short time after surgery, but this quickly goes away. Compensatory sweating can occur. This is excessive sweating on the back, abdomen, thighs or lower legs. This sweating can be described as mild to moderate in nature. Also gustatory sweating, a condition in which a person may sweat while eating or smelling certain food increases, this is also rare.