Lago G, Bertozzi N, Sanese G, Fante C and Raposio E
University of Parma, Italy University of Rome Tor Vergata, Italy
Scientific Tracks Abstracts: J Univer Surg
Statement of the Problem: Hyperhidrosis is a frequent disorder with an estimated prevalence of 3% in the general population. This condition carries relevant impairments in social relationships for the patients. Hyperhidrosis can affect different anatomical areas with palmar region being the most disturbing for everyday activities and social relevance. Several conservative and topical treatments are available for the patients but their efficacy is often limited and temporary. Video-assisted thoracoscopic sympathicotomy of T2 and T3 ganglia with a minimally invasive technique might represent a definitive treatment for palmar and axillary hyperhidrosis.
Methodology & Theoretical Orientation: This minimally invasive approach for thoracoscopic sympathicotomy was first described by Raposio et al., two decades ago. This single-entry thoracoscopic procedure is carried out with a specifically modified endoscope equipped with optic fiber and a wire loop for electrocautery at its distal end. Since 1995, 760 patients have been treated in our department with this surgical technique.
Findings: Out of 1520 thoracoscopic video-assisted sympathicotomy performed in the last 20 years, 1428 resulted in complete resolution of palmar hyperhidrosis. In 46 subjects, the procedure could not be completed due to the presence of vascular structures overlying sympathetic ganglia. In 6 patients symptoms relapsed after the procedure, most likely due to accessory sympathetic pathways. Only 2 patients complained of generalized compensatory hyperhidrosis.
Conclusion & Significance: Video-assisted thoracoscopic sympathicotomy represents a definitive treatment for palmar and axillary hyperhidrosis and it should be considered when conservative options failed to relieve the symptoms. This minimally invasive approach provides effective resolution for this disorder with minimal postoperative complication rate.
Recent Publications
1. Raposio E and Caruana G (2015) Video-assisted thoracic sympathicotomy for the treatment of palmar and axillary hyperhidrosis: a 17-year experience. Surg Laparosc Endosc Percutan Tech. 25(5):417-9.
2. Raposio E, Filippi F, Renzi M, Caregnato P, Capello C and Santi P L.(2001) Minimally-invasive endoscopic transthoracic sympathectomy of the upper limbs. A new method. Minerva Chir. 56(2):193-7.
3. Raposio E, Filippi F, Nordström RE and Santi P (1998) Endoscopic transthoracic dorsal sympathectomy for the treatment of upper extremity hyperhidrosis: a new minimally invasive approach. Plast Reconstr Surg. 102(5):1629-32.
Lago G has completed his Graduation from University of Padova, Italy. During his medical school he has developed interest in Plastic Surgery and before graduation he has participated in several research projects, especially in the field of tissue bioengineering. After his graduation he moved to USA, where he worked as Research Fellow at Brigham and Women’s Hospital in Boston. Later he returned to his home country and started his Residency program in Plastic and Reconstructive Surgery at the University of Parma, Italy.
E-mail: gianluigi.lago@gmail.com
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