Thoracic surgery 

Thoracoscopic Sympathectomy

day:Tuesday

Patient: a 9 year-old girl

Patients with primary hyperhidrosis (excessive sweating) have the option of undergoing a surgical procedure called thoracoscopic sympathectomy. The operation is also known 

as endoscopic thoracic sympathectomy or minimally invasive thoracic sympathectomy.

The sweat glands are stimulated by nerve fibers that arise from the spinal cord and run along each side of the spine in what is called the sympathetic chain. The thoracoscopic sympathectomy interrupts the sympathetic chain, preventing the nerve signals that originate in the spine from reaching and stimulating the sweat glands. This sympathetic chain is interrupted by cutting it which is an irreversible procedure.

The sweat glands in each area of the body are controlled by nerves that arise at a specific level of the spine; therefore, the sympathetic chain must be interrupted only at the specific level that controls the affected areas. For primary hyperhidrosis of the hands, the sympathetic chain is interrupted at the level of the third to fourth rib.