Treatment of Hyperhidrosis with Endoscopic (thoracoscopic or VATS) Sympathectomy Surgery

Image: Illustration of an endoscopic sympathectomy procedure to resolve “hyperhidrosis” or sweating of the hands

Endoscopic surgery has special applications for treatment of sympathetically mediated disorders (sweaty palms and some pain disorders) that require minimally invasive procedures in the thoracic cavity. Treatment of hyperhidrosis in the past was done through a large posterior spinal incision and was not always successful. Dr Johnson has been one the original pioneers of developing endoscopic technology to treat this socially debilitating disorder and has published widely, taught many of the surgeons doing these procedures today and lectured worldwide on this particular topic and procedure. Hyperhidrosis is an unusual disorder that is variable from mild sweating in the hands to severely sweating hands that is treated with a short endoscopic procedure on the sympathetic nerve in the chest along the spinal column.


Image: Sweating of the hands in hyperhidrosis

Johnson JP, Khairi S, Welch E. Surgery of the Sympathetic Nervous System. In: Benzel EC (ed.) Spine Surgery: Techniques, Complication Avoidance, and Management 2nd Edition, Elsevier Churchill Livingstone, Philadelphia, Pennsylvania, 2005, pp 1357-1366.

Johnson JP, Stokes JK, Oskouian RJ, Choi WW, King W: Image-guided thoracoscopic spinal surgery: a merging of two technologies.  Spine 30(19): E572-E578, October 2005.

Image: Illustration of the sympathetic ganglion chain that is the primary treatment for severe hyperhidrosis

Johnson JP, Patel NP: Uniportal and biportal
endoscopic thoracic sympathectomy. Neurosurgery
51(5 suppl): 79-83, Nov 2002.

Johnson JP, Filler AG, McBride DQ: Endoscopic thoracic discectomy.

Neurosurgical Focus 9 (4): Article 11,
October 2000.

Johnson JP, Obasi C, Hahn MS, Glatleider P: Endoscopic sympathectomy.  Journal of Neurosurgery: Spine 91:90-97, 1999.

Image: Young patient treated treated for hyperhidrosis in the early years when they had procedures on separate occasions