September – 2010

Endoscopic Lumbar Sympathectomy for Focal Plantar Hyperhidrosis Using the Clamping Method

Update – An important new joint peer reviewed medical paper, between surgeons in Austria and Brazil, was published carefully studying 163 plantar hyperhidrosis (excessive foot sweating) patients with very similar results further correlating the findings of Dr. Reisfeld in his new paper.

A summary of the first 63 patients that underwent lumbar sympathectomy with the clamping method has now been published by Dr. Reisfeld. Dr. Reisfeld’s findings are published in the journal Surgical Laparoscopy Endoscopy & Percutaneous Techniques, titled: Endoscopic Lumbar Sympathectomy for Focal Plantar Hyperhidrosis Using the Clamping Method. In this paper the experience gained by Dr. Reisfeld performing the operation with the clamping method is outlined including difficulties, pitfalls and results.

Paper Abstract:
Surgical treatment for focal plantar hyperhidrosis is not yet well studied. Bilateral endoscopic lumbar sympathectomy (ELS), using the clamping method, was performed in 63 patients with focal plantar hyperhidrosis. Clamps were placed at L3 (46.0%) or L4 (52.4%), with one case at L2. All patients had improvement in foot sweating, with 96.6% achieving total anhidrosis. Five early cases had to be converted to an open surgical method. Complications were rare. No sexual problems were reported by the male patients. Compensatory sweating, already present in those with prior thoracic sympathectomy (n=56), remained unchanged in 91.1% and no severe compensatory sweating occurred in those who had only ELS. Postoperative pain was minimal. ELS is a viable option in the treatment of plantar hyperhidrosis, whether after a thoracic sympathectomy or in primary cases of plantar hyperhidrosis. Use of the clamping method provides good results with minimal postoperative pain or other complications.

With this careful work Dr. Reisfeld demonstrates that Lumbar Sympathectomy using the clamping method is as good as the excisional method. Dr. Reisfeld believes that less dissection and less usage of electrocautery produces less pain. The overall success rate ranged from 96% to 97%. Obviously in these type of operations years of long-term follow-up will be needed to fully establish accurate statistical data.

Dr. Reisfeld and his colleagues are very pleased with the current results gathered so far. They continually working to advance this type of sympathetic surgery.

Click here to view the entire paper:
Endoscopic Lumbar Sympathectomy for Focal Plantar Hyperhidrosis Using the Clamping Method

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