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Abstract
Physiological sweating from cutaneous eccrine glands maintains normo-thermia and skin hidration. Properly hidrated palmar skin contributes to the effectiveness of normal grip (Collin, 2000).
Essential hyperhidrosis is a condition with excessive sweating localized to certain parts of the body (Lee, 2000).Severe hyperhidrosis palmaris represents a disabling problem for many patients (Kesler, 2000).
Hyperhidrosis of unknown aetiology is successfully treated by severance or resection of the upper thoracic sympathetic chain, thus making surgical intervention the modality of choice in severe cases (Hashmonai, 2003).
Treatment of sympathetic mediated syndromes affecting the upper extremities including hyperhidrosis, pain syndromes (causalgia or reflex sympathetic dystrophy), and Raynaud’s syndrome are the primary indications for thoracoscopic sympathectomy (Lee, 2000).
Different surgical approaches have been used to reach the thoracic ganglia, T2 and T3, which are responsible for sympathetic innervation of the palm and T4 supplies the axillary region (Zacherl, 1999).
Open sympathectomy is often accompanied by a considerably high morbidity. The incidence of Horner’s syndrome for instance, ranges from 10% to 43% (Hashmonai, 1992).