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Thoracic sympathectomy

A procedure used to treat excessive sweating in the hand or arm, and flushing in the face

A thoracic sympathectomy is an operation to cut or cauterise a part of the sympathetic nervous system. It is performed using arthroscopy – keyhole surgery.

It is most often used to control hyperhidrosis – excessive sweating.

This is part of the “fight or flight” response, to dump heat from muscles out into the environment.

This can overact and a solution is to remove the nerve connections causing the problem.

A thoracic sympathectomy can also be used to control certain cardiac arrythmias caused by the same nervous system problem.

A general anaesthetic will be used. This means not eating or drinking in the period leading up to the surgery.

Small incisions will be made in the chest to allow access for the instruments. A lung may be deflated to provide room and visibility.

Once the target nerves are cut or cauterised then the process is reversed, the lung expanded, and the incisions stitched or sutured. 

The anaesthetic will usually require an overnight stay in hospital to recover from.

The small incisions will usually heal within a week. Normal, light, activities can be undertaken upon the return home, the day after the operation.

Heavy workouts or physical labour should wait a week. A week off work is recommended. 

There are small risks to all surgery concerning infection, bruising and bleeding.

These will all be monitored. The two specific risks to a thoracic sympathectomy are that the lung does not reflate properly and that nerves other than the target set might be damaged.

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