Originally Released: March, 1999
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More than 200,000 Americans suffer from an embarrassing problem that interferes with their work and social life -- excessive sweating. The palms of their hands, the soles of their feet, and sometimes their armpits, chest or back are constantly dripping wet. Now, surgeons at the University of Maryland Medical Center are able to use a minimally invasive procedure to cure the problem, which is known as hyperhydrosis.
"The surgery we perform to correct hyperhydrosis requires only one small incision on each side of the chest. Patients have minimal discomfort. Their hospital stay is less than 24 hours and they can return to work after one week," says Mark Krasna, M.D., director of thoracic surgery at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine.
During the surgery, called sympathectomy, doctors cut the sympathetic nerve at a specific location in the upper chest, near the shoulder blade. The body's overstimulation of that nerve is believed to be responsible for excessive sweating. Dr. Krasna says the other functions of the sympathetic nerve, which relate to blood vessel dilation and pain sensation, are not disrupted by the surgery.
Using "videoscopic" techniques, surgeons use scopes attached to a video camera that are inserted through small, one-inch incisions. That way, they can watch what they are doing on a video monitor in the operating room instead of making a large incision. The University of Maryland Medical Center has performed more of these procedures than any other hospital in the region, and currently treats about 50 patients a year.
Dr. Krasna has been a pioneer over the past several years in adapting videoscopic techniques to chest and lung procedures, enabling a variety of patients to benefit from less discomfort and a faster recovery.
There are some non-surgical therapies for hyperhydrosis, including lotions, oral medications and biofeedback, but they do not cure the problem and are not effective for the majority of patients, according to Dr. Krasna. The surgical option is offered to people who have exhausted other medical treatments. The success rate of the surgery depends on where the problem is the worst.
"This minimally-invasive surgery is successful in about 90 percent of patients who have excessively sweaty palms. For those whose problem is most pronounced in the soles of their feet, it works about 75 percent of the time, and about half of the people we treat with excessive armpit sweating get significant relief as a result of this procedure," says Dr. Krasna.
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