Endoscopic procedures to the thoracic sympathetic chain in children

Following our extensive experience with the 'open' transaxillary approach over a period of 20 years, we are presently using thoracoscopy for upper thoracic sympathectomy in severe primary hyperhidrosis. We have performed over 200 sympathectomies during the last 5 years. No conversion to open technique was ever necessary. The immediate postoperative course was uneventful in 98% of patients. Two patients required intercostal drainage for a residual pneumothorax. Over 98% of patients were satisfied with the results. The advantages of the thoracoscopic approach to sympathectomy are obvious: minimal operative trauma, easy postoperative course, short hospitalization, good cosmetic results, and quick return to normal activities.