Many people suffer from hyperhidrosis, whether palmar hyperhidrosis (excessive sweating of the hands) or underarm hyperhidrosis (excessive sweating under the armpits), and cutting the sympathetic nervous system can be considered a safe way to treat hyperhidrosis in Turkey.
But this method remains a last resort when all other treatments fail.
Reasons Excessive sweating
Sweat production is generally beneficial to humans so that they can compensate for the temperature by evaporation.
The sweat secreted on the palms of the hands and soles of the feet also improves adhesion when running or gripping.
However, as it is known, heavy sweating can also be annoying. Due to the unpleasant odor of hyperhidrosis, which is not formed in the newly secreted sweat, but arises only from the decomposition of certain substances in the hand, this sweating can occur without physical exertion.
However, the exact cause is often unknown. Increased sweating can continue or be intensified due to stress factors or physical activity.
In this article, we will discuss the treatment of sweating.
Increased sweating can be observed especially more in the armpits (axillary hyperhidrosis) as well as on the palms of the hands and feet, but it can also occur in principle in all other areas of the body.
If the sweating on the face and head, hands and armpits, or on the feet is very strong, then treatment of excessive sweating by disconnecting the sympathetic nervous system may be considered.
Diagnosis of hyperhidrosis
First, the patient with hyperhidrosis is asked and physically examined.
The sweating severity measurement is then used to determine if the intervention was reasonable.
Further tests, such as blood tests, are necessary for the operation. The doctor must continue to find the cause of excessive sweating, because serious diseases such as tumors can sometimes be the cause of severe hyperhidrosis (secondary sweating).
Increased sweating is obvious, but the severity of the disease and the possible causes for the appearance of excessive sweating in one of the body places must be determined.
Methods for treating excessive sweating
First, you should try procedures that can reduce sweating and help treat the problem naturally.
This includes cutting down on smoking and consuming fewer caffeinated beverages.
Antiperspirants may also be used to reduce the production of sweat. If these simple anti-excessive sweating options don't help, a special form of treatment to combat excessive sweating can work.
Since in addition to the operation there are other treatment methods, doctors mainly offer an option Botulinum toxin injections (Botox)This active substance is injected to block the effect of sympathetic nerves on the sweat glands and thus treat hyperhidrosis under the armpits in particular.
In some cases, special electrical stimulation in a water bath (ion separation) can improve the condition if the hands or feet sweat a lot.
Laparoscopic surgery to treat excessive sweating
If general procedures to treat excessive sweating do not work, the operation can be helpful. If there is excessive sweating in the armpits, the sweat glands can be removed by suction.
Careful consideration should be given to detaching the sympathetic nervous system. The operation is usually successful for severe hyperhidrosis, but it does have certain risks.
The sympathetic nervous system can be disconnected in case of hyperhidrosis of the hands and armpits.
It is also possible to use it with increased sweating on the feet (due to the separation of nerves in the lumbar spine), but at present it is not used often due to the risk of loss of sexual function.
Sympathetic division is performed under general anaesthesia. Small cuts are made in the skin in several places on the chest wall to insert an optical device (thorascope) with a precise video camera and surgical tools between the ribs.
With the help of carbon dioxide gas, the cavity between the lungs and the chest wall is expanded to give a better view of the operation area.
The sympathetic nerve is located on the back wall of the chest. The wire can be attached by stapling, damaged by thermal coagulation, cut or partially removed.
The nerve cord can be attached to the right, left, or both sides, depending on the affected area.
In the vast majority of cases, the procedure is performed on both sides.
At the end of the operation, the incoming gas is absorbed again so that the lungs return to normal volume.
Drain tubes are sometimes inserted to remove any air that is still present.
After the surgical instruments are pulled out, the small incisions are sutured.
Possible additional procedures for operation
In the event of unexpected results or complications, it may be necessary to extend the operation or modify the method.
It may be necessary to switch from laparoscopic surgery to open surgery.
Surrounding anatomical structures or organs can be injured during the operation.
This can lead to primary and secondary bleeding, and can also lead to nerve damage, which can often lead to temporary sensitivity disturbances or paralysis.
If certain points of the sympathetic nerve cord or ganglia are affected, Horner's syndrome can occur with ptosis and pupil constriction. y
Heart rate can drop, and blood pressure can drop as well.
Furthermore, inflammation, disturbances in wound healing, and visible scarring with potential functional or aesthetic effects can occur.
If air enters the chest cavity and forms (pneumothorax), shortness of breath may form immediately after the operation. Also, allergic reactions of varying severity cannot be ruled out.
Sometimes, for example, in the torso area, what is called compensatory sweating occurs after the operation, which cannot be expected in terms of extent and strength.
Occasionally, increased sweating can occur with certain odors or food components (gustatory sweating).
Instructions for patients before and after treatment of hyperhidrosis
before the operation
Medications that negatively affect blood clotting, such as Marcomar or Aspirin, often need to be cut back in consultation with a doctor.
After the operation
There may be problems with breathing and coughing, and therefore the mucus that has formed, although it may be painful, must be removed, so painkillers can be considered.
Standing can be difficult, so another person must be present when straightening the patient for the first time after the procedure.