Skip to main content

Surgical Difficulties and Complications of Video-Assisted Thoracoscopic for Thoracic Sympathectomy

  • Chapter
  • First Online:
  • 774 Accesses

Abstract

This chapter discusses the most common technical difficulties during the surgical procedure of sympathectomy, as well as the most frequent surgical complications, based on the literature and experience of the group with more than 2000 operated cases. The most frequent and most compromising technical difficulty is the presence of pleural adhesions. The most frequent immediate complication is the air fistula, and the most frequent late complication is compensatory sweating.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Suggested Reading

  • Adar R, Kurchin A, Zweig A, Mozes M. Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Ann Surg. 1977;186:34–41.

    Article  CAS  Google Scholar 

  • Andrade Filho LO, Kuzniec S, Wolosker N, Yazbec G, Kauffman P, de Campos JRM. Technical difficulties and complications of symphatectomy in the treatment of hyperhidrosis: an analysis of 1731 cases. Ann Vasc Surg. 2013;27(4):447–53.

    Article  Google Scholar 

  • Andrews BT, Rennie JA. Predicting changes in the distribution of sweating following thoracoscopic sympathectomy. Br J Surg. 1997;84:1702–4.

    Article  CAS  Google Scholar 

  • Asking B, Svartholm E. Degeneration activity; a transient effect following sympathectomy for hyperhidrosis. Eur J Surg Suppl. 1994;572:41–2.

    Google Scholar 

  • Atherton WG, Morgan WE. False aneurysm of an intercostal artery after thoracoscopic sympathectomy. Ann R Coll Surg Engl. 1997;79:229–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Atkins HJB. Sympathectomy by the axillary approach. Lancet. 1954;1:538–9.

    Article  Google Scholar 

  • Cameron AEP. Complications of endoscopic sympathectomy. Eur J Surg Suppl. 1998;580:33–5.

    Google Scholar 

  • de Campos JRM, Kauffman P, Werebe EC, Andrade Filho LO, et al. Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg. 2003;76:886–91.

    Article  Google Scholar 

  • de Campos JRM, et al. The body mass index and level of resection. Predictive factors for compensatory sweating after sympathectomy. Clin Auton Res. 2005;15:116–20.

    Article  Google Scholar 

  • Chiou TS-M, Chen S-C. Intermediate-term results of endoscopic transaxillary T2 sympathectomy for primary palmar hyperhidrosis. Br J Surg. 1999;86:45–7.

    Article  CAS  Google Scholar 

  • Drott C, Claes G, Gothberg G, Paszowski P. Cardiac effects of endoscopic electrocautery of the upper thoracic sympathetic chain. Eur J Surg Suppl. 1994;572:65–70.

    Google Scholar 

  • Duarte JBV, Kux P. Efficacy of endoscopic thoracic sympathectomy along with severing the Kuntz nerve in the treatment of chronic non-infectious rhinitis. Ann Chir Gynaecol. 2001;90:189–92.

    CAS  PubMed  Google Scholar 

  • Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin. 2008;18:193–207.

    Article  Google Scholar 

  • Dumont D, Denoyer A, Robin P. Long-term results of thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg. 2004;78:1801–7.

    Article  Google Scholar 

  • Franz Marhold F, Izay B, Zacherl J, Tschabitscher M, Neumayer C. Thoracoscopic and anatomic landmarks of Kuntz’s nerve: implications for sympathetic surgery. Ann Thorac Surg. 2008;86:1653–8.

    Article  Google Scholar 

  • Gossot D, Grunenwald D, et al. Early complications of thoracic endoscopic sympathectomy: a prospective study of 940 procedures. Ann Thorac Surg. 2001;71:1116–9.

    Article  CAS  Google Scholar 

  • Gossot D, Galetta D, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg. 2003;75(4):1075–9.

    Article  Google Scholar 

  • Gossot D, Grunenwald D, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Eur J Cardiothorac Surg. 2005;27:741–4.

    Article  Google Scholar 

  • Herbst F, Fugger R, Fritsch A, et al. Endoscopic thoracic sympatectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations. Ann Surg. 2002;89:158–62.

    Google Scholar 

  • Hughes J. Endothoracic sympathectomy. Proc R Soc Med. 1942;35:585–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kauffman P, Wolosker N, de Campos JRM, Yazbec G, Jatene FB. Azygos lobe: a difficulty in video-assisted thoracic sympathectomy. Ann Thorac Surg. 2010;89(6):57–9.

    Article  Google Scholar 

  • Kopleman D, Bahous H, Assalia A, Hashmonai M. Upper dorsal sympathectomy for palmar hyperhidrosis. Use of the harmonic scalpel versus diathermy. Ann Chir Gynaecol. 2001;90:203–5.

    Google Scholar 

  • Lai YT, Yang LH, et al. Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy. Neurosurgery. 1997;41:110–3.

    Article  CAS  Google Scholar 

  • Lai CL, Chen WC, Liu YB, Lee YT. Bradycardia and permanent pacing after bilateral thoracoscopic T2sympathectomy for primary hyperhidrosis. Pacing Clin Electrophysiol. 2001;24:524–5.

    Article  CAS  Google Scholar 

  • Lange JF. Inferior brachial plexus injury during thorascopic sympathectomy. Surg Endosc. 1995;9:830.

    CAS  PubMed  Google Scholar 

  • Lin CC. http:// www.sweathand.com.

  • Lin TS, Fang HY. Transthoracic endoscopic sympathectomy in the treatment of palmar hyperhidrosis—with emphasis on perioperative management (1,360 case analyses). Surg Neurol. 1999 Nov;52(5):453–7.

    Article  CAS  Google Scholar 

  • Lin CC, Telaranta T. Lin-Telaranta classification: the importance of different produce of for different indications in sympathectomy surgery. Ann Chir Gynaecol. 2001;90(3):161–6.

    CAS  Google Scholar 

  • Lin C-C, Mo L-R, Hwang M-H. Intraoperative cardiac arrest: a rare complication of T2,3-sympathicotomy for treatment of hyperhidrosis palmaris. Two case reports. Eur J Surg Suppl. 1994;572:43–5.

    Google Scholar 

  • Lin CC, Lee LS, et al. The haemodynamic effect of thoracoscopic cardiac sympathectomy. Eur J Surg Suppl. 1998a;580:37–8.

    Google Scholar 

  • Lin CC, et al. Thoracoscopic T2-sympathetic block by clipping – a better and reversible operation for treatment of hyperhidrosis palmaris: experience with 326 cases. Eur J Surg Suppl. 1998b;580:13–6.

    Google Scholar 

  • Ojimba TA, Cameron AE. Drawbacks of endoscopic thoracic sympathectomy. Br J Surg. 2004;91(3):264–9.

    Article  CAS  Google Scholar 

  • Ramsaroop L, Partab P, Singh B, Satyapal KS. Thoracic origin of a sympathetic supply to the upper limb: the ‘nerve of Kuntz’ revisited. J Anat. 2001;199(Pt 6):675–82.

    Article  CAS  Google Scholar 

  • Ramsaroop L, Partab P, Singh B, et al. Anatomical basis for a successful upper limb sympathectomy in the thoracoscopic era. Clin Anat. 2004;17:294–9.

    Article  CAS  Google Scholar 

  • Reisfeld R. http://www.sweaty-palms.com/reversal_ets.html.

  • Riet M, et al. Prevention of compensatory hyperhidrosis after thoracoscopic sympathectomy for hyperhidrosis. Surg Endosc. 2001;15:1159–62.

    Article  CAS  Google Scholar 

  • Ross JP. Sympathectomy as an experiment in human physiology. Br J Surg. 1933;21:5–19.

    Article  Google Scholar 

  • Shachor D, Jedeikin R, Olsfanger D, Bendahan J, Sivak G, Freund U. Endoscopic transthoracic sympathectomy in thetreatment of primary hyperhidrosis. A review of 290 sympathectomies. Arch Surg. 1994;129:241–4.

    Article  CAS  Google Scholar 

  • Telaranta T. Secondary sympathetic chain reconstruction after endoscopic thoracic sympathectomy. Eur J Surg. 1998;164(Suppl 580):17–8.

    Google Scholar 

  • Telaranta T. Reversal surgery for reducing the side-effects of ETS. A case report. Ann Chir Gynaecol. 2001;90:175–6.

    CAS  PubMed  Google Scholar 

  • Telaranta T. http://www.privatix.fi.

  • Zacherl J, Herbst F, et al. Video assistance reduces complication rate of thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg. 1999;68:1177–81.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Laert de Oliveira Andrade Filho .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Andrade Filho, L.d.O., Engel, F.C. (2018). Surgical Difficulties and Complications of Video-Assisted Thoracoscopic for Thoracic Sympathectomy. In: Loureiro, M., Campos, J., Wolosker, N., Kauffman, P. (eds) Hyperhidrosis. Springer, Cham. https://doi.org/10.1007/978-3-319-89527-7_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-89527-7_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-89526-0

  • Online ISBN: 978-3-319-89527-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics