Dr.Reisfeld has performed this procedure more than any other doctor in the US. He takes great care in making sure his patients are comfortable and well taken care of.
Endoscopic thoracic sympathectomy for hyperhidrosis: experience with both cauterization and clamping methods.
Reisfeld R, Nguyen R, Pnini A.
Summary:
The goal was to review results of sympathectomy, performed with use of either cauterization or clamping, in patients with hyperhidrosis (n = 1,312): 653 early patients undergoing electrocautery sympathectomy, 305 later patients undergoing cauterization, and 354 patients treated with a clamping procedure. Patients were interviewed by telephone about the status of symptoms, adverse outcomes, and satisfaction. Palmar hyperhidrosis was cured in all but one patient, with a 98% satisfaction rate in the clamping group and 94.3% and 95.1% in the two cauterization groups ( < /= 0.025, clamping > cauterization). Facial sweating or blushing was cured in the majority (88%) of the 301 patients reporting this symptom. Severe compensatory hidrosis occurred in less than 6% (3% of the clamping group; < /= 0.001, clamping < cauterization). Recurrence rate was 3.0%. A number of factors were related to outcome. Endoscopic thoracic sympathectomy with clamping appears to be at least as safe and effective as earlier cauterization techniques, with the potential advantage of reversibility in those patients unhappy with the outcome.
Independent Studies / Methods
"Between January 1995 and January 2000, 47 patients underwent a bilateral thoracoscopic sympathectomy as described earlier. The indications for thorascopic sympathectomy were excessive hyperhidrosis palmaris et axilaris, rubeosis, or both. Patient data are given in Table 1. All patients were interviewed and physically examined 3 months after discharge to assess the results of the procedure and their satisfaction with the treatment.
Results
All patients except one were satisfied with the results of their treatment. After 3 months, all patients had dry hands and axillary regions. There were no perioperative or postoperative deaths..."
Table 1
| Variables |  |
Data |
| Women:Men | 30:17 | |
| Age Range (y) | 15 - 37 | |
| Average Age (y) | 27 | |
| Indication for treatment (n) | ||
| Hyperhidrosis palmaris et axillaris | 23 | |
| Hyperhidrosis and rubeosis | 19 | |
| Rubeosis | 5 |
Posterior Approach for the Simultaneous, Bilateral Thorascopic Sympathectomy - The American COllege of Surgeons Vol 192, No 3 March 2001
"From March 1992 to August 1999, 63 ETS procedures were performed in 34 patients. There were 14 male patients (41.2%) and 20 female patients (58.5%). The mean age was 22 years (range 10-50). The indications for surgery were hyperhidrosis in 26 patients, upper extremity ischemia in 3 patients, splanchnic pain and RSD in 2 patients each, and 1 facial blushing patient.
No procedure had to be converted to open thoracotomy, and no perioperative complications were detected. There were no major postoperative complications, including Horner syndrome. The mean hospital stay was 1.1 days. The median follow-up time for the whole group was 1.6 years (range 1 month to 7 years). Preoperative symptoms resolved completely or improved significantly in 97.1% (33/34) of the patients."
Thoratic Sympathectomy - Surgical Laparoscopy, Endoscopy & Percutaneus Techniques Vol. 10, 5, pp. 314-318
"After 20 years of experience with the "open" transaxilary approach, the authors are presently performing the thorascopic technique for upper thoracic sympathectomy in severe primary hyperhidrosis. During a period of 14 months 23 operations were performed and 22 patients had immediate and permanent relief of palmar sweating. The immediate postoperative course was uneventful in all cases. Hospitalization was short, and all patients returned to school and full activity 3 to 5 days after operation."
Thoracoscopic Upper Thoracic Sympathectomy for Primary Palmar Hyperhidrosis in Children and Adolescents - 1995 by W.B Saunders Company