Robotic Surgery For Hyperhidrosis?

Discussions regarding the use of robotic devices when performing thoracic or lumbar sympathectomies are ongoing. In a thoracic sympathectomy (ETS) robots offer no practical role. The setup of a robotic surgical device takes a long time before the surgery can begin.

During this setup, a human surgeon can complete ETS for both sides. The incisions needed for a robotic approach are larger. In Dr. Reisfeld’s opinion, the motivations to try this approach are mainly financial. Since the mid-1990’s we are able to achieve extremely high success rates coupled with excellent safety records using a non-robotic approach.

Robotic surgery is a newer technique that should only be used in certain cases where endoscopic surgery cannot achieve the same level of success and safety. That being said, Dr. Reisfeld’s opinion is that robotic surgery for hyperhidrosis (ETS, ELS) is unnecessary. Plantar hyperhidrosis (foot sweating treatment) can be treated in a very safe and efficient manner with excellent results using an endoscopic lumbar sympathectomy,

In this time of rising healthcare costs, keeping the price down is very important. Using robotic surgery, the total price can be 2-3 times as much. Recently, It has become possible to utilize a robotic tool to complete the procedure with one incision.

This incision is larger than the 1-3 small incisions used in the ETS or ELS procedures. A larger incision increases pain, results in a bigger scar, and also carries the possibility of hernia formation when the procedure is done for a lumbar sympathectomy.

Pros of robotic surgery
For this particular surgery, Dr. Reisfeld believes there are no advantages over an endoscopic surgery.

Cons of robotic surgery

  • Unnecessary. It increases the cost of the surgery
  • Requires a larger incision
  • The entire procedure takes longer
  • A more complex procedure sometimes requires more surgeons