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
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