Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limb

The procedure

The aim of the procedure is to permanently stop the palms and underarms sweating by cutting off the nerve signals to the sweat glands in the arm.

The patient is usually given a general anaesthetic. Small cuts are made in the armpit to open a space between the ribs into the chest then the lung is partly deflated. An endoscope and surgical instruments are inserted into the chest cavity and parts of the nerves responsible for sweating, which lie alongside the spinal column in the chest, are either cut or clamped. The instruments are removed, the lung reinflated and the cuts closed. The procedure is then repeated on the other side of the body.