Hyperhidrosis pp 163-169 | Cite as

Evolution of Surgical Methods and Difficulties Relating to Endoscopic Thoracic Sympathectomy

  • Paulo Kauffman


Based on experience gained at the Hyperhidrosis Outpatient Clinic of the Hospital of Clínicas of São Paulo, Brazil, with videothoracoscopic thoracic sympathectomy, in this chapter the evolution of the surgical method—including anesthesia, the patient’s position on the surgical table, and the target segment of the sympathetic chain, as well as the contraindications and difficulties encountered in performing the surgical procedure, particularly in the presence of the azygous lobe—are described.


Primary hyperhidrosis Thoracic sympathectomy Sympathetic surgery Azygous lobe Pleural adhesions 

Suggested Reading

  1. Campos JRM, Kauffman P, Gomes O Jr, Wolosker N. Video-assisted thoracic sympathectomy for hyperhidrosis. Thorac Surg Clin. 2016;26:347–58.CrossRefGoogle Scholar
  2. de Andrade Filho LO, Kuzniec S, Wolosker N, Yazbek G, Kauffman P, Milanez de Campos JR. Technical difficulties and complications of sympathectomy in the treatment of hyperhidrosis: an analysis of 1731 cases. Ann Vasc Surg. 2013;27(4):447–53.CrossRefGoogle Scholar
  3. Kauffman P, Wolosker N, de Campos JR, Yazbek G, Jatene FB. Azygos lobe: a difficulty in video-assisted thoracic sympathectomy. Ann Thorac Surg. 2010;89:e57–9.CrossRefGoogle Scholar
  4. Wolosker N, Kauffman P. Upper extremity sympathectomy. In: Cronenwett J, Johnston KW, editors. Rutherford’s vascular surgery. 8th ed. Philadelphia: Saunders; 2014. p. 1923–33.Google Scholar
  5. Yazbek G, Wolosker N, Kauffman P, Campos JR, Puech-Leão P, Jatene FB. Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics (Sao Paulo). 2009;64:743–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Paulo Kauffman
    • 1
  1. 1.Department of Vascular and Endovascular SurgeryUniversity of São Paulo School of MedicineSão PauloBrazil

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