Hackensack University Medical Center Thoracic Surgeon Specializes in Selective Sympathectomy Technique

Refined approach results in fewer side effects–including compensatory sweating–for patients with hyperhidrosis

December 11, 2024

Hackensack University Medical Center thoracic surgeon Michael Spallone, M.D. is utilizing robotic surgery to advance the technique of sympathectomy by employing a more selective approach for the treatment of hyperhidrosis.

This undertreated condition causes excessive sweating of the palms, axillae, soles of the feet, and face. When medical treatments are ineffective or not tolerated, the traditional surgical approach may be used, which involves dividing a large chain of sympathetic system nerves running adjacent to the spine on each side in the chest.

While this traditional method boasts a success rate of over 95%, particularly for palmar and axillary sweating, it frequently leads to compensatory sweating in other parts of the body such as the trunk or soles of the feet. Although many patients accept this tradeoff, there is potential for a better surgical approach to reduce these side effects in this condition that is estimated to affect up to 5% of Americans.

Dr. Spallone offers this innovative surgical technique, known as selective sympathectomy, to minimize the risk of compensatory sweating. Utilizing the DaVinci robotic surgery platform for enhanced visualization and precision, he targets the smaller nerve fibers branching from the main nerve bundle, rather than dividing the entire nerve chain.

The procedure involves three 1-cm incisions on each side of the chest. Both sides can be completed at the same time, and patients are typically released from the hospital on the same day.

While the procedure is only performed on a fraction of potentially eligible patients, it can provide a drastic and immediate improvement in quality of life, both from a social and functional perspective. For example, one of Dr. Spallone’s patients was a medical student afraid to shake hands, and another was a police officer facing challenges holding his weapon before the elective procedure.

Dr. Spallone discovered selective sympathectomy from a former colleague and took it upon himself to learn the technique to improve patient care and outcomes. This commitment to continuous education is ingrained in the Hackensack University Medical Center thoracic surgery team’s culture. Their team approach and dedication to excellence ensures that patients receive the most advanced and effective treatments available, whether for hyperhidrosis or other thoracic conditions.

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