You will be under a general anesthetic before surgery. This will make you asleep and pain-free.
The surgery is usually done the following way:
- The surgeon makes 2-4 tiny cuts (incisions) under one arm on the side where the excessive sweating occurs.
- Your lung on this side is deflated (collapsed) so that air does not move in and out of it during surgery. This gives the surgeon more room to work.
- A tiny camera called an endoscope is inserted through one of the cuts into your chest. Video from the camera shows on a monitor in the operating room. The surgeon views the monitor while doing the surgery.
- Other small tools are inserted through the other cuts.
- Using these tools, the surgeon finds the nerves that control sweating in the problem area. These are cut.
- Your lung on this side is inflated.
- The cuts are closed with stitches (sutures).
- A small drainage tube may be left in your chest for a day or so.
After doing this procedure on one side of your body, the surgeon may do the same on the other side. The surgery takes about 1 to 3 hours.
Surgery is successful 98-99% for the hands, 75% for the armpits and variable for the facial blushing.
You can usually go home on the same day of the operation.
You should not drive for 24 hours after the operation. You can go back to work usually after 2 days.
The risks here are a guide; your own risk may vary.
You may get various sensations, ranging from numbness to discomfort or pain that is usually controlled by pain killers. These may happen in the upper back, armpit or front of the chest. They usually resolve after a few weeks.
Air around the lung or under the skin can happen and usuakky resolves on its own. Slow heart beats can happen. The heart takes nerves from the same level as the hands. This happens lees than 1% of the cases.
Horner’s syndrome (droopy eyelid) can happen in 1% of cases. This maybe temporary or permanent.
Sweating in the rest of the body is a common problem after sympathectomy. The body over reacts to the cut nerves by stimulating the sweat glands in the rest of the body in upto 80% of patients. This can be very annoying to some patients and you should be aware of it.
There are medications and non surgical options that should be considered before surgery. Dermatology opinion should be sought for topical, oral, LASER and iontophoresis.