Single-Port Endoscopic Thoracic Sympathectomy with Monitored Anesthesia Care: A More Promising Procedure for Palmar Hyperhidrosis.

Objectives: Thoracic sympathectomy is considered the most effective method to treat palmar hyperhidrosis. We presented a novel procedure for thoracic sympathectomy treating palmar hyperhidrosis which could be performed under monitored anesthesia care. The aim of this study was to evaluate the continuing efficacy and safety of this innovative surgery.

Method: From May 2011 to May 2014, we performed the single-port endoscopic thoracic sympathectomy (ETS) with a flexible thoracoscopy in 32 patients under monitored anesthesia care. All patients were followed up until today.

Results: Under monitored anesthesia, all patients were awake during the procedure. A proper sedation and local anesthesia make it possible for patients to communicate with surgeons. The symptoms disappeared immediately when the sympathectomy was done. No surgical complications occurred during the procedure. All patients were discharged from the hospital on the first morning of postoperative day. Compared with the traditional approach, the advantages of less operative costs, fewer hospital days, and better recovery were suggested.

Conclusions: Single-port ETS with flexible thoracoscopy under monitored anesthesia is a promising procedure for palmar hyperhidrosis.