Accumulating experience since 1995 shows that the overall satisfaction and the good results of dry hands is applicable to about 95% of the patients. In this group the patients often talk about how the surgery was a very positive life changing experience. Self-confidence and social skills are often improved which can help those patients a lot. Again remember results are different for each patient.
There are two main issues that lowers the overall satisfaction rate.
A) Recurrence which happens to about 2% of the patients
B) Compensatory sweating
For some unexplained reasons recurrence of the sweating can happen no matter which method was used. Excision, cauterization and clamping all bear the same rate. The most plausible explanation is the creation of extra anatomical bypass (connections) that leads to resumption of nerve impulses to the hands or feet. The sweat glands are acting after they get nerve signals from the sympathetic chain. Resumption of those signals can happen in a few ways among them is the possibility that signals are going up and down the spinal cord and exit the sympathectomy site at a higher or lower level. We believe that more understanding of neural pathways in the brain as well as in the spinal cord might shed more light into this problem. So far no definite solution exists. In cases of thoracic sympathectomy it is easier to do a redo operation with good results but it is so much more difficult to perform a redo operation in endoscopic lumbar sympathectomy. In any case the recurrence rate is still low and acceptable as long as the recurrence is not as high as before the operation.
B) Compensatory Sweating
This is the most commonly mentioned side effect. Everyone who is having sympathectomy , thoracic or lumbar will develop a certain level of compensatory sweating. Statistically speaking the majority of the patients up to 94-95% will have an acceptable level of compensatory sweating which allows them to continue with a normal way of life. Like in any other elective operation there will always be a certain number of patients who will not be satisfied with the level of their compensatory sweating. It is unavoidable and we wish that we could who will have a high or acceptable level of compensatory sweating but we simply cannot at this point.
Patients who had previous ETS are their compensatory level stabilized and now they come for endoscopic lumbar sympathectomy might experience fluctuation of their compensatory sweating that stabilized over the years. The body after ELS and previous ETS is going through a new set of nerve signals and time is needed for stabilization. Time is of the essence because our body is capable of finding a lot of solutions on its own.