"He knows the procedure is controversial because of the unpredictability of side-effects"

Information about surgery for sweaty hands: surgeon "knows the procedure is controversial because of the unpredictability of side-effects"



"Ferrar believes much of the controversy lies in surgeons, mainly in America, who perform the surgery on anyone who asks for it, rather than the severe end of the spectrum.
"In America there are so many that have been operated on when it hasn't been necessary, or the surgeon has given the patient false expectations, that there are support groups for people who've had complications or adverse effects. The people that come to me are almost self-selecting; they've tried everything else."
The youngest patient he has performed an endoscopic thoracic sympathectomy on was 8 years old, with most being in puberty (when the condition tends to arise). Or they are in their 20s when they are beginning relationships and jobs."



Publication info: Waikato Times [Hamilton, New Zealand] 07 Apr 2012: 22."

Chest pain, chest hypersensitivity, arm pain, paraesthesias of the upper limb and the thoracic wall, and recurrent pain in the axillary region have all been described

"Chest pain, chest hypersensitivity, arm pain, paraesthesias of the upper limb and the thoracic wall, and recurrent pain in the axillary region have all been described. Intra-operative intrapleural analgesia using bupivacaine can help reduce postoperative pain. Using a 5 mm rather than 1cm post causes less postoperative discomfort, particularly in women with narrow intercostal spaces."

Complications in Vascular and Endovascular Surgery: How to avoid them and how to get out of trouble


Jonothan J Earnshaw, Michael Wyatt,

tfm Publishing Limited, Jan 1, 2012 - Medical - 318 pages

Sympathectomy is by no means a benign procedure, and sympathectomy for sweating can induce pain and allodynia

"As to sympathetic block, or sympathectomy, Seddon (1964) when writing of acute ischaemia said 'let us hope that the completely futile sympathetic block will not have been done'. Birnstingl (1982), vascular surgeon to the Royal National Orthopaedic Hospital for some years, said 'sympathetic block is useless'; sympathectomy has no place in the treatment of acute ischaemia..." (p. 308)



"Sympathectomy is by no means a benign procedure, and sympathectomy for sweating can induce pain and allodynia at the border zone which is sometimes associated with pronounced increase in sweating in that area." (p. 534) Surgical Disorders of the Peripheral Nerves by Rolfe Birch Springer, Jan 21, 2011 - Medical - 512 pages original article published in Ann R Coll Surg Engl 2002; 84:181-184"

peripheral sympathectomy causes a dramatic increase in NGF levels in the denervated organs

Increased Nerve Growth Factor Messenger RNA and Protein

Peripheral NGF mRNA and protein levels following
sympathectomy
It has been shown previously that peripheral sympathectomy
causes a dramatic increase in NGF levels in the denervated
organs (Yap et al., 1984; Kanakis et al., 1985; Korsching and
Thoenen, 1985).
Increased ,&Nerve Growth Factor Messenger RNA and Protein
Levels in Neonatal Rat Hippocampus Following Specific Cholinergic
Lesions
Scott R. Whittemore,” Lena Liirkfors,’ Ted Ebendal,’ Vicky R. Holets, 2,a Anders Ericsson, and HBkan Persson
Departments of Medical Genetics and’ Zoology, Uppsala University, S-751 23 Uppsala, Sweden, and *Department of
Histology, Karolinska Institute, S-104 01 Stockholm, Sweden