What is Thoracoscopic Sympathectomy?
Thoracoscopic sympathectomy, also referred to as video-assisted thoracoscopic surgery (VATS) sympathectomy, is a keyhole operation that interrupts part of the sympathetic nerve chain in the chest. These nerves control sweating in the hands, armpits, and face. By dividing or clamping the relevant section of the nerve chain, the signals that trigger excessive sweating are permanently interrupted.
Who is it Suitable For?
Thoracoscopic sympathectomy is most effective for palmar hyperhidrosis (excessive hand sweating) and facial hyperhidrosis (excessive facial sweating and blushing). It is considered for patients whose sweating is severe enough to significantly affect daily life, work, and social confidence, and who have not achieved adequate relief from non-surgical treatments such as topical antiperspirants, iontophoresis, or botulinum toxin injections.
How is the Operation Performed?
The operation is performed under general anaesthetic. Three or four very small incisions are made under each arm, and a thin camera (thoracoscope) along with fine instruments are introduced into the chest cavity. The relevant section of the sympathetic nerve chain is identified and either clipped or divided under direct vision. Both sides are treated during the same anaesthetic. The operation typically takes 45 to 90 minutes and most patients stay one night in hospital.
Recovery, Results, and Compensatory Sweating
Most patients experience immediate and dramatic improvement in hand or facial sweating following surgery. Recovery is generally quick, with most people returning to normal activities within one to two weeks.
The most important side effect to be aware of is compensatory sweating: increased sweating in another part of the body, most commonly the back, abdomen, or thighs. This occurs to some degree in the majority of patients and can range from mild to significant. Dr Garbowski will discuss this in detail at your consultation so you can weigh the benefits of the operation against this well-recognised trade-off.
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Conditions we can treat with Thoracoscopic Sympathectomy (VATS)
Below are some of the conditions we can treat with Thoracoscopic Sympathectomy (VATS). Click on the below to learn more or get in touch with us to request a consultation.
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Frequently Asked Questions
Thoracoscopic sympathectomy (VATS) is a minimally invasive surgical procedure that interrupts the sympathetic nerve chain in the chest, which controls sweating. Small keyhole incisions are used to access and divide or clip the relevant nerve fibres. It is most effective for palmar and facial hyperhidrosis.