Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.180072
Jornal Vascular Brasileiro
Innovation

Minilaparoscopic lumbar sympathectomy with 3 mm instruments for plantar hyperhidrosis

Simpatectomia lombar endoscópica com microinstrumental de 3 mm para hiperidrose plantar

Marcelo Loureiro; Arlindo Nascimento de Lemos Junior; Paolo Rogerio Oliveira Salvalaggio; Mohammad Alwazzan

Downloads: 0
Views: 130

Abstract

Abstract: Severe palmoplantar hyperhidrosis affects about 1.5-2.8% of the general population. Plantar hyperhidrosis (PHH) is related to foot odor, cold feet, skin lesions and infections, and even instability when walking. Endoscopic Lumbar Sympathectomy (ELS) is the treatment of choice for this condition. However, few surgeons have used this technique over the past 20 years because of its technical difficulty. Two and 3 mm instruments, rather than the standard 5 mm instruments, have been used to improve the results of several standard laparoscopic procedures. Use of these minilaparoscopic instruments to perform ELS so far has not yet been published. We describe a technique for ELS using minilaparocopic instruments, which we have used for our last 70 cases and has become our standard technique. The aim of this study is to demonstrate the feasibility of this technique and its advantages compared to the conventional technique.

Keywords

sympathectomy, endoscopic lumbar sympathectomy, plantar hyperhidrosis

Resumo

Resumo: A hiperidrose palmoplantar grave afeta cerca de 1,5-2,8% da população geral. A hiperidrose plantar está relacionada a odor dos pés, pés frios, lesões cutâneas, infecções, e até instabilidade da marcha. A simpatectomia lombar endoscópica (endoscopic lumbar sympathectomy, ELS) é o tratamento de escolha para essa condição; entretanto, tem sido utilizada por poucos cirurgiões nos últimos 20 anos, devido à sua dificuldade técnica. Instrumentos de 2 e 3 mm em vez de 5 mm vêm sendo utilizados para melhorar os resultados de vários procedimentos laparoscópicos padrão. O uso desses instrumentos para realizar ELS ainda não foi descrito. Descrevemos a técnica para ELS usando microinstrumentos, a qual vem sendo usada para os nossos últimos 70 casos, pois passou a ser nosso procedimento padrão. O objetivo deste estudo é apresentar a experiência com essa modificação técnica, assinalando as vantagens em relação à técnica tradicional.
 

Palavras-chave

simpatectomia, simpatectomia lombar endoscopica, hiperidrose plantar

References

1 Ro KM, Cantor RM, Lange KL, Ahn SS. Palmar hyperhidrosis; evidence of genetic transmission. J Vasc Surg. 2002;35(2):382-6. http://dx.doi.org/10.1067/mva.2002.119507. PMid:11854739.

2 Strutton DR, Kowalski JW, PharmD, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004;51:41-8. http://dx.doi.org/10.1016/j.jaad.2003.12.040.

3 Rieger R, Pedevilla S, Pöchlauer S. Endoscopic lumbar sympathectomy for plantar hyperhidrosis. Br J Surg. 2009;96(12):1422-8. http://dx.doi.org/10.1002/bjs.6729. PMid:19918855.

4 Reisfeld R, Pasternack G, Daniels P, Basseri E, Nishi G, Berliner K. Severe plantar hyperhidrosis: an effective surgical solution. Am Surg. 2013;79(8):845-53. PMid:23896256.

5 Hourlay PG, Vangertruyden F, Verduyckt F, Trimpeneers JH, Hendrickx J. Endoscopic extraperitoneal lumbar sympathectomy. Surg Endosc. 1995;9(5):530-3. http://dx.doi.org/10.1007/BF00206845. PMid:7545831.

6 Carvalho GL, Loureiro MP, Bonin EA. Renaissance of minilaparoscopy in the NOTES and single port era. JSLS. 2011;15(4):585-8. http://dx.doi.org/10.4293/108680811X13176785204832. PMid:22643524.

7 Loureiro MP, Campos JRM, Kauffman P, Jatene FB, Weigmann S, Fontana A. Endoscopic lumbar sympathectomy for women: effect on compensatory sweat. Clinics. 2008;63(2):189-96. http://dx.doi.org/10.1590/S1807-59322008000200006. PMid:18438572.

8 Rieger R, Loureiro MP, Pedevilla S, Oliveira RA. Endoscopic lumbar sympathectomy following thoracic sympathectomy in patients with palmoplantar hyperhidrosis. World J Surg. 2011;35(1):49-53. http://dx.doi.org/10.1007/s00268-010-0801-0. PMid:20862474.

9 Carvalho GL, Loureiro MP, Bonin EA, et al. Minilaparoscopic technique for inguinal hernia repair combining transabdominal pre peritoneal and totally extraperitoneal approaches. JSLS. 2012;16(4):569-75. http://dx.doi.org/10.4293/108680812X13462882737096. PMid:23484566.

10 Loureiro M, Sultan A, Alhaddad M, et al. Needlescopic sleeve gastrectomy: pushing the boundaries of the standard technique. Surg Endosc. 2017;31(10):4256-7. http://dx.doi.org/10.1007/s00464-017-5419-y. PMid:28236013.
 

5eb2f1d20e88258e33d76ee0 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections