Biportal thoracoscopic sympathectomy: Surgical techniques and clinical results for the treatment of hyperhidrosis

Patrick P. Han, Oren N. Gottfried, Kathy J. Kenny, Curtis A. Dickman

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


OBJECTIVE: To describe a bilateral thoracoscopic syrrtpathectomy procedure, using a biportal approach, for the treatment of severe hyperhidrosis. METHODS: Between May 1996 and September 2000, 103 consecutive patients underwent thoracoscopic sympathectomy procedures to treat bilateral hyperhidrosis (206 procedures). Operative results, complications, and patient satisfaction were determined by reviews of hospital and office charts and by follow-up assessments in the outpatient clinic. Long-term results were determined with clinical examinations, follow-up office visits, and follow-up questionnaires. RESULTS: Ninety-three patients presented with primary palmar hyperhidrosis, eight with primary axillary hyperhidrosis, and two with primary craniofacial hyperhidrosis. Rates of complete resolution in the primary area affected were 100% in palmar and craniofacial cases and 75% in axillary cases. The average length of hospitalization was 1.06 days, and 96 patients (93.2%) were discharged on or before the end of the first postoperative day. Of 59 patients (57.3%) who developed compensatory hyperhidrosis, only 11 patients (10.7%) reported that it was bothersome and none considered it disabling. All postoperative complications were transient; five patients experienced unilateral Horner's syndrome, three patients experienced intercostal neuralgia, and two patients required a chest tube after surgery because of a pneumothorax. CONCLUSION: Thoracoscopic sympathectomy using a biportal approach effectively treats hyperhidrosis and is associated with short hospital stays, high patient satisfaction rates, and low rates of compensatory hyperhidrosis or other complications.

Original languageEnglish (US)
Pages (from-to)306-311
Number of pages6
Issue number2
StatePublished - Feb 2002
Externally publishedYes


  • Biportal
  • Compensatory hyperhidrosis
  • Hyperhidrosis
  • Thoracoscopic sympathectomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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