Deep inside your chest, a structure called the sympathetic nerve chain runs up and down along your spine. It is the part of the nervous system responsible for the fight or flight response. During a sympathectomy, a surgeon cuts or clamps this nerve chain. This keeps nerve signals from passing through it.
This procedure is used to treat a condition called hyperhidrosis or abnormally heavy sweating in the palms of the hands, the face, the underarms, and sometimes the feet. It's also used for facial blushing, some chronic pain conditions and Raynaud phenomenon — a condition that leads to profound sensitivity to cold temperatures and color changes of the skin. After a sympathectomy, the brain can't send signals to the involved areas to make them sweat, blush, or react to the cold as much. This permanent procedure is used as a last resort if other steps, such as antiperspirants or medicines, haven't worked.
As with any surgery that requires anesthesia, risks include breathing problems or reactions to the medicines used to help you relax during the procedure. Other possible risks include:
You may have other risks, based on your specific medical condition. Be sure to talk with your healthcare provider about any concerns you have before the procedure.
Ask your healthcare provider to tell you what you should do before your sympathectomy. Below is a list of common steps that you may be asked to do.
Before the surgery, you will be given medicine (anesthesia) so you go to sleep. You won't feel or remember the procedure. The surgeon will make 2 to 3 small incisions (cuts) on one side of your chest below your underarm. Next, your lung will be temporarily collapsed and moved aside to allow the surgeon to reach the nerve chain along your spine.
The surgeon will then insert a small video camera and surgical tools to view and maneuver the nerve chain. Next, the surgeon will cut or clamp the nerve chain at the right level, depending on your exact symptoms.
When finished, the surgeon will re-expand the lung, remove the camera and instruments, and sew shut the incision. Then the surgeon will repeat the procedure on your other side. The entire surgery takes about an hour.
Talk with your healthcare provider about what you will experience during your sympathectomy.
After the procedure, you will be taken to the recovery room for observation. Your recovery process will vary depending on the type of procedure done and the type of anesthesia that is given. The incision sites will be checked often. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.
Most people can go home the day after the surgery. You should plan to have someone give you a ride home.
You may resume your normal diet unless your healthcare provider advises you differently.
You may feel pain for a week afterward. Your healthcare provider may suggest that you take over-the-counter or prescription pain medicine.
Ask your healthcare team how to keep the incisions clean. Avoid soaking in the tub or going swimming for 2 weeks.
You can probably do your normal activities after the surgery. But, you may need to take it easy at first. No heavy lifting or vigorous exercises until your body has healed.
Most people can return to work within a week.
Be sure to take all of your medicines as prescribed and to attend any follow-up visits that your healthcare provider schedules.
Before you agree to the test or the procedure make sure you know:
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