Endoscopic lumbar sympathectomy for focal plantar hyperhidrosis using the clamping method.

Surgical treatment for focal plantar hyperhidrosis is not yet well studied. Bilateral endoscopic lumbar sympathectomy (ELS), using the clamping method, was performed in 63 patients with focal plantar hyperhidrosis. Clamps were placed at L3 (46.0%) or L4 (52.4%), with one case at L2. All patients had improvement in foot sweating, with 96.6% achieving total anhidrosis. Five early cases had to be converted to an open surgical method. Complications were rare. No sexual problems were reported by the male patients. Compensatory sweating, already present in those with prior thoracic sympathectomy (n=56), remained unchanged in 91.1% and no severe compensatory sweating occurred in those who had only ELS. Postoperative pain was minimal. ELS is a viable option in the treatment of plantar hyperhidrosis, whether after a thoracic sympathectomy or in primary cases of plantar hyperhidrosis. Use of the clamping method provides good results with minimal postoperative pain or other complications.