Thoracoscopic ganglionectomy for hyperhidrosis.

Thoracoscopic sympathectomy for the treatment of hyperhidrosis has been carried out with techniques that involve either monopolar coagulation or laser injury to the T2 ganglion. Although this has the advantage of being minimally invasive, it has not been established whether these techniques are superior to complete ganglion excision, as carried out during open surgery. A new technique of complete T2 ganglion excision for palmar hyperhidrosis (with T3 ganglionectomy for axillary sweating) was developed using thoracoscopic techniques. Sixteen patients were treated with thoracoscopic T2 ganglion excision on the right side, and simple coagulation (Nd-YAG laser or monopolar) on the left side. Results were excellent with no posttreatment differences between hands at 1 year follow-up. However, long-term follow-up of these patients will be carried out to determine whether differences exist between these two techniques.