Hyperhidrosis pp 131-145 | Cite as

Surgical Techniques for the Realization of Thoracic Sympathectomy

  • Eduardo de Campos Werebe
  • Carlos Levischi
  • Rodrigo Sabbion


With the advent of video and advancement in endoscopic video-assisted techniques, the thoracoscopic approach, first described by Kux in 1951, has undergone rapid progression and is now widely accepted as the approach of choice to perform sympathectomy. Other discussions have arisen regarding the technique used: to cut, clip, or resect the upper thoracic sympathetic chain is accepted as the approach of choice, with minimal postoperative morbidity and near faultless success rate, but the optimal technique remains a subject of controversy. Some authors prefer either resection of the chain, or clipping the chain, while others prefer electrocautery ablation of the ganglia. The uniportal technique has now emerged, in an effort to minimize surgical trauma and speed up the procedure. In this chapter we discuss all of the techniques used, considering discussion and concerns arising about them, and describe their final results.


Sympathectomy Eletrocautery Clip method Harmonic scalpel Resection of the chain 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eduardo de Campos Werebe
    • 1
  • Carlos Levischi
    • 1
  • Rodrigo Sabbion
    • 1
  1. 1.Hospital Israelita Albert EinsteinSão PauloBrazil

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