It is the appropriate method for the treatment of hyperhidrosis. The innervation of the sweat glands by the sympathetic nervous system. It is an exaggerated stimulus that reaches the glands, through the sympathetic nervous system, which determines sweating. Sympathicotonia, for the treatment of palmar, axillary and facial hyperhidrosis, is the section of certain points of the sympathetic nerve trunk, located inside the thoracic cavity. With that, the nervous stimulus for the sweat of the stopped glands and perspiration disappears.
* Dr. Kux was the creator of the thoracic endoscopic sympathectomy technique in the late 1930s, where the penetration of the thoracic cavity is done through puncture. The first endoscopic sympathectomy for the treatment of hyperhidrosis was carried out by Drs. Erhard Kuk and his nephew, Peter Kux, in 1947, in Germany. Because it is less aggressive than the conventional technique, which used large surgical incisions in the chest or neck, endoscopic chest sympathectomy, it has become the technique of choice for the treatment of hyperhidrosis.
With more than 39 years’ experience with endoscopic sympatheticotomy and more than 2,600 surgeries performed in 1992, the team (Dr. Peter Kux and Dr. João Bosco Vieira Duarte) started to adopt videoendoscopy in their surgeries. With the introduction of the video, technical and tactical changes were made. The procedure became even safer, the result improved and indications increased.
The patient is discharged on the same day. There is no need to stay in the hospital.
Recovery is quick and return to activities as well.
Example of compensatory sweating.
In some cases, after surgery, increased sweating, usually in the abdomen and / or lower back and / or lower limbs, can be called compensatory hyperhidrosis. The incidence varies according to the location of the hyperhidrosis and the technique used. Usually, it disappears with the passage of time, however, it can be persistent.
For cases of compensatory hyperhidrosis, the team developed a technique that illuminates the problem in selected cases.
“Dr. João Bosco,
I write only to give news about the result of the surgery performed. The observed results are consistent with your forecast. I don’t have hyperhidrosis in the trunk, above the waist, in the upper limbs, or hands. I am living with a better quality of life, more available and joy. There is compensatory sweating in the lower limbs when the room temperature is high or when I exercise. This is normal, as I need to eliminate toxins.
You asked me if there is spontaneous sweating when the room temperature is cold or during the night. Fortunately, this did not happen. I just shimmered in the legs, when the room temperature is hot or during exercise. I hope I helped to compose the data in statistical analysis. I am satisfied with the results.
A hug from your friend from Rio de Janeiro”
Other complications are rare with this method.
It is a procedure of choice in our clinic for selected patients with hyperhidrosis only in the axillary region.
It consists of curettage (scraping) of the skin dermis of the axillary region in which the sweat glands are located. Simultaneously with the partial removal of the gland, the sympathetic innervation of the region is sectioned, increasing the chance of cure, which is 85% in our experience.
It consists of removing the skin segment in the armpits, rich sweat glands. The result varies according to the size of the withdrawal area. the formation of hypertrophic scarring can occur, which limits the movement of the upper limb.
It has already been used in the treatment of axillary hyperhidrosis, however, the dose required for the disappearance of excessive sweating can lead to serious complications such as actinic dermatitis, fibrosis and retraction of the axillary skin, which limits the movements of the upper limb.