Perspiration is a necessary function to control body temperature, and is regulated by the sympathetic system. However, for around 2.5% of the population this system does not function correctly, i.e. there is an excessive stimulus of the sweat glands and an intense production of sweat in certain parts of the body, a situation referred to as hyperhidrosis.
The most common and annoying form of hyperhidrosis affects the palms of the hands, which causes discomfort in social relationships (greeting with a handshake), as well as in work activities (handling electronic components, delicate merchandise, aesthetic treatments).
Axillary hyperhidrosis is also frequent and equally uncomfortable and embarrassing because it stains most clothing.
Plantar hyperhidrosis greatly restricts the daily life of patients, mainly in the choice of footwear and also because of the impossibility of using open shoes in the summer.
Craniofacial hyperhidrosis is excessive sweating of the face and scalp. This situation cannot be “disguised”, so there are people who stop doing certain everyday activities and many say that the situation has affected their professional growth.
Minimally Invasive Treatment
The permanent treatment for hyperhidrosis is Bilateral Video-Assisted Thoracic Sympathectomy. It has been known for some time but until just a few years ago it was not possible to perform the surgery in a simple and minimally-invasive way.
Video-assisted and minimally invasive thoracic surgery revolutionised the treatment of hyperhidrosis by allowing the interruption of the sympathetic innervation selectively and permanently, with a success rate of 98%, in the case of hands and underarms.
The surgery is performed under local anaesthesia, allowing the patient to go home on the same day and back to work two days later.
How is the surgery performed?
The surgical procedure consists of placing a small titanium clip that blocks the ganglia of the sympathetic nerve responsible for sweating in the zone in question, immediately and definitively solving the problem of excessive sweating.
To place the clip, two tiny incisions are made under the armpits and, with a 3 or 5 mm endoscopic camera and minimally invasive surgery, it is possible to access the nerve.
This technique is a recent solution that makes it possible to reverse the possible side effects of surgery which, in our experience, may occur in fewer than 3% of cases.
Are there any side effects?
In a small percentage of patients (1-2%), so-called compensatory hyperhidrosis can occur; a slight increase in sweating on the back and abdomen, normally well tolerated and substantially preferable to sweating hands and underarms. Using titanium clips means that in case of compensatory hyperhidrosis, the procedure can be reversed by removing the clips, meaning that this technique is a “reversible surgery”.
The specialist consultation in Hyperhidrosis is the responsibility of Professor Javier Gallego, Cardiothoracic Surgeon, who is perhaps the doctor with the most experience in this surgical procedure, in Portugal and even in Europe.
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