In a sympathectomy, a surgeon cuts a portion of a nerve inside the chest, permanently interrupting the nerve signal that causes the body to sweat excessively.
Joseph Coselli, MD, a surgeon at Baylor College of Medicine in Texas, says his patients are amazed to wake up from surgery with their hands completely dry for the first time in years. Unlike other treatments, a sympathectomy is designed to be a one-time, permanent procedure.
In the past, a sympathectomy was a major surgery because it required opening up the chest or back. Today, it is an outpatient procedure performed with tiny instruments and a camera that are inserted into the body through a small incision, a method known as endoscopy.
But the surgery remains controversial because of a phenomenon called compensatory hyperhidrosis. While sweating may disappear from the hands and armpits, it may increase elsewhere in the body, such as chest, back or legs.
Dermatologist Dee Anna Glaser, MD, of Saint Louis University says the surgery should be considered a treatment of last resort because half or more of sympathectomy patients suffer from compensatory sweating.
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