Laparoendoscopic single-site retroperitoneal lumbar sympathectomy: Initial report

Background: Retroperitoneoscopic lumbar sympathectomy is a safe and effective treatment for plantar hyperhidrosis. Objective: To evaluate the safety and feasibility of laparoendoscopic single-site retroperitoneal lumbar sympathectomy in plantar hyperhidrosis. Methods: Bilateral laparoendoscopic single-site retroperitoneal lumbar sympathectomy was performed in a 27-year-old man who suffered from excessive sweating from the soles of the feet. A homemade single port was created with an Alexis wound retractor through a 2.5-cm incision at the tip of the 12th rib. With conventional 5-mm laparoscopy and instruments, retroperitoneal lumbar sympathectomy was performed. Results: The procedure was completed successfully without any complications and with minimal blood loss. The operative time was 110 and 80 minutes for the procedure on the left and right sides. The perioperative course and postoperative course were uneventful. The patient had anhidrosis of both feet after surgery with Hyperhidrosis Disease Severity Scale score of 1 at the 1-month follow-up. Conclusion: Laparoendoscopic single-site retroperitoneal lumbar sympathectomy is a safe and feasible procedure according to our initial experience.