Surgical Treatment

To surgically treat sweaty palms or underarms, a small part of the sympathetic nerve responsible for excessive sweating is removed. In the past, this required a large incision in the chest. Many muscles were cut and ribs separated to expose the sympathetic nerve chain. Recent surgical advances have produced less invasive procedures, such as the endoscopic thoracic sympathectomy.

This procedure requires general anesthesia and typically takes less than one hour to complete. Once the patient is asleep,
Dr. Joseph Coselli makes two or three small (1/8 inch to 1/4 inch) incisions below the armpit. Through these tiny holes, a miniature video camera is used to locate the sympathetic chain. Dr. Coselli uses special instruments, inserted through
the other incisions, to remove a small segment of the nerve. The same procedure is then performed on the opposite side
of the patient's body.

The patient usually remains in the hospital for an additional
12-24 hours following surgery. Most patients experience mild post-operative discomfort requiring oral pain medication. This usually goes away after 7 to 10 days.

The success rate for this type of procedure is 85-95 percent with very few side effects and a very low failure rate. Most people who undergo this procedure are permanently cured.

Side Effects

There are a few side effects including compensatory hyperhidrosis and Horner's syndrome.

Compensatory hyperhidrosis occurs when the patient experiences excessive sweating in other areas of the body, such as the chest, back and legs. This is the most common side effect, but most patients find this condition to be manageable.

Horner's syndrome occurs when other nearby nerves are irritated during the surgical procedure. Patient's may experience a droopy eyelid, dilated pupils, and decreased sweating of the face on the affected side. This side effect is extremely rare, and has greatly decreased in frequency as surgical techniques have improved over the past several years.