Patients with palmar hyperhidrosis suffer from excessive sweating of the hands, which can affect up to 3% of the population with significant impact on their quality of life. There are many factors that can contribute to cause palmar hyperhidrosis, but often it is due to a hypersensitive sympathetic nervous system that controls the eccrine sweat glands. Conservative treatments may help in selected patients, such as anticholinergic drugs, antiperspirants, iontophoresis, or botulinum toxin.

For patients who remain symptomatic after conservative treatment, surgery can be offered in the form of sympathectomies, which involve the cauterization of the sympathetic chain above and below the selected nerve ganglion within the chest cavity. Using a minimally invasive robotic approach, Associate Professor Christopher Cao is able to identify and cauterize the collection of neurons within the chest that controls sweating in the palms and arms. Typically, this is performed to both sides of the chest within the same admission to achieve immediate symptomatic improvement.