Modified R5-R8 Thoracic Sympathectomy for Severe Compensatory Hyperhidrosis.

Compensatory hyperhidrosis is the most frequent complication after thoracic sympathectomy applied in the treatment of localized hyperhidrosis. It affects the quality of life in patients, especially in social, professional, and affective spheres. The present study aims to describe the operative technique of bilateral thoracic sympathectomy from R5 to R8 by videothoracoscopy as an optimized resolution of compensatory hyperhidrosis. The R5-R8 technique allows shorter surgical time, better ergonomics, more satisfactory aesthetic outcome, and reduction of postoperative morbidity. Severe compensatory hyperhidrosis treatment remains a challenge.