The patient is a 19-year-old male who has experienced excessive sweating in his hands, feet, and armpits since the age of 9. Although this condition has no significant effect on his physical health, it has brought great inconvenience to his daily life and studies. Additionally, the hyperhidrosis has profoundly affected his personality, making him feel increasingly inferior, sensitive, and fearful of having social interactions. After entering puberty, the patient’s palmar hyperhidrosis continued to worsen, prompting him to seek treatment through traditional Chinese medicine. However, the symptoms not only did not improve but became more severe.

Later, the patient learned that his symptoms were caused by excessive activation of the sympathetic nervous system, which could be cured through minimally invasive surgery. However, when he informed his parents of his intention to undergo the surgery, they failed to understand and opposed the idea. This is also a common frustration shared by many hyperhidrosis patients—the impact of hyperhidrosis on patients' mental health and daily life has not been given sufficient attention and recognition as it deserves.

After that, the patient had to endure the discomfort caused by hyperhidrosis for 10 years. At the age of 19, as he was about to graduate from university, he finally decided to undergo surgery to completely get rid of hyperhidrosis.

Under general anesthesia, an ultra-high-definition thoracoscopic sympathectomy was performed. A small incision, approximately 5-8 mm in size, was made in each armpit. A 5 mm ultra-high-definition thoracoscope was utilized to sever the T4 sympathetic nerve chains on both sides, which control sweating. The operation took only 10 minutes. After the surgery, the patient’s hand sweating improved significantly, with no noticeable compensatory sweating observed. There was only slight compensatory sweating on the thighs and calves.