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Sweaty FeetExcessive sweating in different locations of the body is known as focal hyperhidrosis. In contrast to excessive sweating all over the body which can described as generalized hyperhidrosis. The most common sites for focal hyperhidrosis are excessive hand sweating, excessive foot sweating and excessive armpit sweating. Conservative measures are available such as medications, lotions or electrical instruments to try and alleviate these problems. Earlier in the history of surgical interventions to treat palmar hyperhidrosis it was thought that plantar hyperhidrosis could be alleviated as well. Unfortunately the success rate in reducing plantar hyperhidrosis (foot sweating) after performing endoscopic thoracic sympathectomy is much less than anticipated. As more experience was gained now a days lumbar sympathectomy is offered as a more effective solution to treat isolated plantar hyperhidrosis or those cases that ETS did not make any difference. The operation of endoscopic lumbar sympathectomy (ELS) is performed under general anesthesia and can be accomplished also on an outpatient basis. It involves three small cuts on either side of the abdominal cavity. The space in between the abdominal cavity and the posterior back muscles is entered into the lumbar region where the sympathetic chain runs. There at a particular location the sympathetic chain is clamped or divided. So far with ELS only the clamping method was used. It gives the surgeon a definite idea about the level at which the nerve was clamped. The less dissection that is required results in a more efficient procedure with less pain. The operation takes about an hour and a half with a success rate of about 96-97%. Usually the amount of pain is quite small and patients are able to go back to their normal day to day life in a very short amount of time. The muscles are not cut but split so there is no loss of muscle power and everything goes back to normal. Side effects include some discomfort and scar formation rarely. Compensatory sweating is usually kept at the same level for those patients who had a previous endoscopic thoracic sympathectomy. For those patients who are having only ELS the compensatory sweating so far did not mature to be of a significant level. See also Dr. Reisfeld's Foot Sweating hyperhidrosis page Obviously conservative approaches should be tried before any consideration of surgical intervention.
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