{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:29:02Z","timestamp":1777937342649,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Primary hyperhidrosis is a debilitating condition characterized by excessive focal sweating, most commonly affecting the axillae, palms, and soles, for which surgical intervention provides a durable solution in patients refractory to medical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We present our outpatient surgical technique for video-assisted thoracoscopic sympathectomy (VATS) using a two-port, 3-mm incision approach and evaluate its efficacy and outcomes. A case series of 33 consecutive patients undergoing outpatient VATS sympathectomy between 2016 and 2023 was reviewed, with 9 patients excluded for lack of postoperative follow-up. All procedures were performed with electrocautery at the third and fourth ribs posteriorly (T3 and T4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The technique demonstrated consistent efficacy in symptom resolution with short operative times, low postoperative pain, and rapid recovery. Mean operative time was 22.0 \u00b1 3.7 minutes, with same-day discharge achieved in all patients. The average pain score at discharge was 2.0 \u00b1 2.6, and no intraoperative or immediate postoperative complications occurred. Symptom severity scores improved across all regions, most notably in the palms (8.8 \u00b1 2.1 to 1.3 \u00b1 2.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and axillae (7.1 \u00b1 2.9 to 2.2 \u00b1 2.3,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), with improvement also observed in plantar sweating (8.6 \u00b1 2.0 to 4.8 \u00b1 3.0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), while facial sweating showed a modest, nonsignificant change (2.3 \u00b1 2.8 to 1.5 \u00b1 2.2,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .21). At 2\u20134 weeks, complication rates, including compensatory hyperhidrosis and pneumothorax, were comparable to conventional methods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This minimally invasive two-port VATS sympathectomy with 3-mm incisions appears safe, effective, and patient-centered, supporting its use as a surgical approach for primary hyperhidrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429251405812","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:56:36Z","timestamp":1767084996000},"page":"238-242","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Thoracoscopic Sympathectomy for Primary Hyperhidrosis: A 3 mm Two-Port Approach"],"prefix":"10.1177","volume":"36","author":[{"given":"Saman","family":"Qadri","sequence":"first","affiliation":[{"name":"Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zummar","family":"Asad","sequence":"additional","affiliation":[{"name":"Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Schott","sequence":"additional","affiliation":[{"name":"Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Heutlinger","sequence":"additional","affiliation":[{"name":"Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sora","family":"Ely","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, The George Washington University, Washington, District of Columbia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Mortman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, The George Washington University Hospital, Washington, District of Columbia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-016-1697-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.12.071"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-022-00743-7"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-022-00707-x"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.03.013"},{"issue":"5","key":"e_1_3_4_7_2","first-page":"5","article-title":"Primary focal hyperhidrosis: Scope of the problem","volume":"79","author":"Glaser DA","year":"2007","unstructured":"Glaser DA, , Hebert AA, , Pariser DM, et al. 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