Dr. YunHai Yang from Zhejiang University, China. He is working in Department of General Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou.


Palmar hyperhidrosis is a common disease that causes intense significant for patients. Bilateral single-port thoracoscopic sympathectomy approach is an effective surgical treatment with high success rates and improvement in quality of life. In order to reduce surgical invasion and seek for better cosmetic results, we describe a novel protocol for thoracic sympathectomy in the treatment of palmar hyperhidrosis. Between January 2012 and September 2012, bilateral thoracic sympathectomy was performed through the anterior mediastinal pleura using the pleura videoscope with a single skin incision in 10 men and 6 women. A total of 16 patients were cured and the skin temperature increased by a mean of (2.7±0.6) 0C. The average operation time of was 67.9±15.8 min, with postoperative hospital stay of 1.9±0.6 days and operative bleeding of less than 20ml. All operations were successful with no severe complications or perioperative mortality. A 9.8±2.3 month (7-14 month) followup showed that palmar sweating improved in all patients and the effective rate was 100%. Single-incision bilateral thoracic sympathectomy through the anterior mediastinal pleura is an effective, feasible, safe and minimally invasive procedure with excellent cosmetic results.