title: Early experience with endoscopic lumbar sympathectomy for plantar hyperhidrosis.
abstract: OBJECTIVE
  We describe our endoscopic lumbar sympathectomy technique and our early experience using it to treat plantar hyperhidrosis.
  
  
  METHODS
  We reviewed 20 lumbar sympathectomies performed in our vascular unit for plantar hyperhidrosis in 10 patients from 2011 and 2014. Demographics and outcomes were analyzed and a review of the literature conducted.
  
  
  RESULTS
  All procedures were carried out endoscopically with no intraoperative or postoperative morbidity. Plantar anhidrosis was achieved in all the patients, although two patients (20%) suffered a relapse. Unwanted side-effects occurred in the form of compensatory sweating in three patients (30%) and post-sympathectomy neuralgia in two patients (20%). None of the patients experienced sexual dysfunction.
  
  
  CONCLUSIONS
  Management of plantar hyperhidrosis may be based upon a therapeutic ladder starting with conservative measures and working up to surgery depending on the severity of the disease. Minimally invasive (endoscopic) sympathectomy for the thoracic chain is well established, but minimally invasive sympathectomy for the lumbar chain is a relatively new technique. Endoscopic lumbar sympathectomy provides an effective, minimally invasive method of surgical management, but long-term data are lacking.
authors.affiliation: Department of General Surgery, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of General Surgery, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK.
authors.forename: Simranjit
authors.initials: S
authors.lastname: Kaur
authors.affiliation: Department of General Surgery, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D005528:Foot; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008160:Lumbosacral Plexus / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013562:Sympathectomy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anhidrosis; endoscopic lumbar sympathectomy; plantar hyperhidrosis