Laparoscopic Superselective Transperitoneal Lumbar Sympathectomy for Treating Plantar Hyperhidrosis

Background: Retroperitoneoscopic lumbar sympathectomyis the standard surgical treatment for plantar hyperhidrosis. However, it is rarely performed due to the technical complexity of the procedure. This study aimed to describe a modified video-assisted lumbar sympathectomy technique, the superselectivetransperitoneal lumbar sympathectomy. Methods: This is a retrospective study of 32 sympathectomies (16 patients) for plantar hyperhidrosis. The procedure is performed with the patient in the supine position and under general anesthesia. A video camera is introduced through the umbilical trocar, and the dissection forceps are introduced through trocars in the suprapubic area and right-and left-iliac fossa. The patient is placed in the Trendelenburg position at the level of the L3 vertebral body.