Minimally Invasive Sympathectomy for Hyperhidrosis

Clinical Services: Cardiothoracic Surgery (Thoracic Surgery)

Upper East Side
525 East 68th Street, M-404
New York, NY 10065

Mon-Fri 09:00am - 05:00pm

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646-962-0203

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(212) 746-5166

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Hyperhidrosis, or over perspiration, is caused by excessive secretion of the sweat glands. This disorder affects a small but significant proportion of young people all over the world. The cause of the sweating is believed to be over stimulation of the sympathetic nerves that supply the offending sweat glands.

Hyperhidrosis is often an uncomfortable or even debilitating condition: patients suffer from social embarrassment at work or school associated with excessive hand, underarm, or facial sweating. Simple tasks such as shaking someone's hands or reading a book can cause embarrassment or anxiety.

Medical therapies can help some patients with hyperhidrosis, but their benefits are temporary.

Expert hyperhidrosis treatment at Weill Cornell Medicine

Thoracic surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center are able to successfully treat hyperhidrosis in a minimally invasive procedure called "endoscopic thoracic sympathectomy (ETS)," which permanently relieves the nerve overstimulation that causes hyperhidrosis.

The ETS procedure takes about 15 minutes, and both sides of the body are completed in the operation. Patients are usually able to leave the hospital a few hours later. Most patients return to work and their daily activities within a week.

Our surgeons have improved the quality of lives of many patients suffering from hyperhidrosis. Ordinary social interactions such as hand shaking are no longer embarrassing or anxiety provoking.

Types of hyperhidrosis treated

• Palmar: Palmar (hand) sweating is the most common complaint in patients with hyperhidrosis.

• Plantar: Some patients experience plantar (feet) sweating alone or in addition to palmar hyperhidrosis.

• Axillary: For excessive sweating in the axillae (underarms), ETS may be considered when medical therapies (Drysol, Drionics®, beta-blockers, Botox® injections, and anticholinergic drugs) fail to relieve symptoms.

• Facial Blushing: Some patients have embarrassing blushing of the face and neck during stressful social situations. Patients with facial blushing may benefit from ETS, though there is greater risk of experiencing sweating elsewhere in the body after ETS than there is for patients who undergo ETS for palmar and axillary sweating.

Why choose Weill Cornell Medicine for hyperhidrosis treatment?

Our patients benefit from:

• Over excellent success rate: 95 percent of patients experience immediate and dramatic relief following ETS

• The most advanced techniques in surgical procedures

• Our excellent network of medical professionals, including oncologists, gastroenterologists, and pathologists, working with our thoracic surgeons to ensure patients receive truly comprehensive care

• Treatments tailored specifically to our individual patients

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FAQ

I am interested in participating in a clinical trial for thoracic conditions. Where can I learn about the current trials at Weill Cornell Medicine?

Learn about our many current trials open to patient participation.

I would like to learn more about my specific condition and treatment options. Which resources do you recommend?

We recommend visiting the Weill Cornell Medicine Cardiothoracic Department website, as well as the National Cancer Institute and the Lung Cancer Research Foundation.

What happens after I schedule my surgery?

Once you and your care team decide that surgery is the best treatment plan for your condition, you will schedule a pre-surgical appointment at M404.

What happens during the pre-surgical appointment?

During your pre-surgical appointment:

• Your nurse practitioner will explain what you can expect for your specific surgery and hospital stay

• Your nurse practitioner will review your current medications

• You will sign a consent form for the surgery and potential blood transfusion (Please note: Most patients do not receive blood transfusions during surgery, but we are required to have you sign this consent form, just in case you do need a transfusion and are not awake at the time to give your consent. ALL blood is stringently tested for HIV, hepatitis, and cytomegalovirus.)

• You have the opportunity to ask questions

• You will receive a small bottle of antibacterial soap

This process generally takes two to three hours.

What do I need to do to prepare for the surgery?

You will be given instructions as to which medications you should stop taking to prepare for surgery.

On the night before your surgery, shower using half of the bottle of antibacterial soap. On the morning of the surgery, before you come to the hospital, shower using the rest of the soap.

Do not eat or drink after midnight the night before your surgery. You may take your medications that the nurse practitioner approved you to take the morning of surgery, with just a small sip of water.

Where should I park for my surgery?

Parking is available in front of the 68th Street circular entrance to the hospital. There are also several parking garages in the immediate area.

Parking is only validated on the day of your hospital discharge, not on the day of your pre-surgical appointment.

What should I bring for my surgery?

Please be sure to bring your:

• Insurance card(s)

• Toiletries

• Pajamas, robe, and slippers

Generally try not to bring too much to the hospital, because you probably won't use a lot of these things and will just have to carry them home.

Please do not bring any jewelry or expensive electronics with you for the first hospital day. Your family and friends are welcome to bring those items once you are awake and in your room.

Where should I go to check in for the surgery?

Please check in at Greenberg 3-West (Same-Day Surgery Unit), which is on the third floor of the Greenberg Pavilion, using the "G" elevators.

If you are the first case, please check in at 6 a.m. If you are the second case, please check in at 10 a.m.

Where should my friends and family members wait during the surgery?

During your surgery, your family and friends should wait in the Ronald O. Perelman Heart Institute Atrium. Please tell them to check in at the front desk so that they can be contacted when your surgeon calls.

If the Ronald O. Perelman Heart Institute Atrium is closed at the time of your surgery, your family and friends may wait in the smaller waiting area right outside the Cardiothoracic ICU (4-West).

There is also a café on the first floor of the hospital, directly opposite the information desk and down the hall from the front door on the left, which is open at all times. This café sells coffee, tea, and a variety of food.

Where can I learn more information about thoracic surgery at Weill Cornell Medicine?

Please see Guide to Lung, Stomach, Medistatial, or Esophageal Surgery.

What does the typical recovery look like? What should I expect?

Pain in and around the incision may last up to several weeks. It is also very common to experience numbness around the incisions as well.

You will be given specific instructions about how to best care for the incisions. It is important to keep the wounds clean; normal soap and water is best for this care.

You can resume driving six weeks after your operation. Your physician will evaluate if you are ready to fly at your follow up appointment.

How long will it take before I can resume my normal routine and activities?

You will likely feel tired for a few days after the operation. We recommend taking short naps and trying to stay awake during the day as long as possible so that you can rest fully at night.

Exercise: Continue to use the incentive spirometer (the blue "ball machine") for the first week or two after you get home, approximately four to five times each day. Two weeks after surgery, you should be doing enough physical activity to stop using the machine.

Try to walk for 20 minutes twice a day when you come home, and slowly increase the frequency and duration of your exercise. You will slowly increase your endurance and energy level.

Diet: For the first one to two months after surgery, eat as much as you can without regard to salt and fat intake. In general, anesthesia will decrease your appetite, so it is important to eat as much as you can during this time to help your body to heal.

If you were on a special diet (such as a low-carbohydrate, diabetic, or kidney diet), continue following this diet after you feel that your appetite has recovered. Your care team will work with you to help determine the best diet to optimize your health.

I have questions about my insurance coverage. Who should I contact?

Please see Insurance Questions or call (212) 746-5161.