Abstract
Primary hyperhydrosis of the upper limb is a distressing and often scially disabling condition. Recent introduction of endoscopy in thoracic procedure lead to consider thorascopic sympathectomy the treatment of choice using diathermy to destroy the sympathetic chain. I have treated 30 patients and 60 transaxillary upper thoracic chains were excised in 12 patients and was not feasible for 3 patients. Thoracic chains were diathermized for 18 patients. The mean operative time for excision group is 35 minutes and 18 minutes in the diathermized group. The immediate post operative course was uneventful in most of the patient. One patient developed temporary Homer's syndrome which resolve completely in 3 month. The mean post operative stay is 1.1 day in both groups. Total abolition of palmar sweating was achieved in all patients. Resound hyperhyrosis occurred in four patients. Endoscopic transthoracic diathermy of the sympathetic chain is safe, efficient, shorter operative time than the excision methods and using 2 trocars only.