Hyperhidrosis is a disease characterized by excessive sweating in the hands, armpits, face and feet, negatively affecting human life (daily activities and psycho-social status).
Is it possible to treat hyperhidrosis?
The treatment is often difficult and various systems are applied. What causes this situation is the multifunction of the part of the border system called the sympathetic border. Thus, treatment options have been developed based on the damage to the ends of the word with various methods. These include topical and systemic spies, iontopheresis (galvenotherapy), botox injections, chemical considerations and radiofrequency, and sympathectomy, which can be performed with surgical procedures. Iontophoresis is applied by immersing the hands and feet in static electric water for half an hour 3 days a week. Although the most frequently applied procedure in recent times is botox injections applied at 1 cm intervals to areas that sweat a lot, its effect usually lasts around 6 weeks and requires repetitive applications. Its disadvantages are that its price is valuable, it causes pain, and its duration of action is short. In addition, various topical spies (aluminum chloride in ethyl alcohol, glutaraldehyde) can be used and require repeated applications. The most definitive and permanent treatment method is to block the border surgically.
How is the surgical treatment system applied?
In sympathetic border system surgery, cutting or burning the sympathetic end, clip-on ETS permanently treats sympathetic disorders. While it was previously performed by making an incision on the chest wall (thoracotomy), nowadays this type of surgical application can be handled quickly and without any problems by experienced surgeons using closed surgical techniques (Endoscopic Thoracic Sympathectomy or clip-on ETS) with the development of image-assisted surgery systems.
Under general anesthesia, it is applied through 2 small incisions of 1-2 cm, one in each armpit. According to the patient’s complaints, the sympathetic borders at the 2nd and 3rd spine levels are cut. The duration of this attempt made from both armpits varies between 20 and 40 minutes, depending on the experience of the physician and the operating room staff. The fact that the patient’s hands are dry quickly after the operation is an indication that the result is obtained quickly.
How soon is discharge possible in the postoperative period?
The patient, who came out of the operation with a chest drain, is discharged the next day after the drain is removed, without leaving any visible scar, and returns to his daily life quickly after that.
What are the issues that the border cut will cause?
Disruption of sympathetic border integrity affects any other function of the body and causes damage to the body (temporary or permanent paralysis, loss of sensation, etc.).
What are the positive results of surgical treatment?
Hand sweating passes by 95-100%. Hands are warm and dry quickly after surgery. Facial flushing disappears in 80-85 individuals out of 100, and facial sweating completely disappears at the rate of 95%. Underarm sweating is eliminated by 85-90% and foot sweating is reduced by 64%. Heart palpitations during excitement are reduced. The self-confidence of individuals increases. It increases their success in business and social life.
Are there any side effects that may occur due to surgical treatment?
This surgery is an extremely reliable procedure if performed by an experienced surgeon. However, although rare, some side effects may occur.
Reflex (compensatory) sweating: It is the most common side effect. It is excessive sweating that occurs in other parts of the body (back, around the navel, hips and back of the knees) after the sweating of the hands, face, armpits and feet has passed. It is seen in 1% after hand and armpit sweating operation, 3-5% after facial sweating operation, 17-20% after facial redness operation.
Gustatuvar sweating: It can be seen at a rate of 3%. It doesn’t bother the person too much. It is the sweating that occurs on the face or body after the intake of certain foods after the operation (it is seen after the intake of bitter or hot foods).
· Horner’s syndrome: It is not seen in our level of sympathectomy.
· Pneumothorax: Sometimes air in the chest cavity outside the lungs can be seen. This is called a pneumothorax. Mostly it passes. Very little air in the chest cavity may need to be evacuated by inserting a tube through the middle of the two ribs.
· Bleeding: In very rare cases, bleeding may occur from veins in the middle of the rib or from veins near the sympathetic chain. This can be seen and controlled during the operation.
Intercostal neuralgia: Sometimes, pain may occur in the arms, back and armpits due to the injury of the borders in the middle of the ribs at the entrances. It passes in about 1-1.5 months. It does not cause much discomfort to the patient.
Operation details:
By preventing the patient from receiving anesthesia (narcosis) a second time in a single session bilaterally (for both hands and armpits)
· Surgery is performed through only 1 entry hole for each side
· The patient exits the surgery without drains.
· You can be discharged on the same day.
