Introduction: Sympathectomy is the only known procedure which can be curative for hyperhidrosis. The minimally invasive approach by retroperitoneoscopy was first described in 1973. Since then, a few case reports have been published describing bilateral retroperitoneoscopic lumbar sympathectomy for plantar hyperhidrosis. We describe the technique of left lumbar retroperitoneoscopic sympathectomy as part of a bilateral procedure for plantar hyperhidrosis.

Methods: A 24 year old female presented with socially debilitating plantar, palmar and axillary hyperhidrosis. She had tried desiccating powders, iontophoresis but did not have lasting relief. She underwent bilateral retroperitoneoscopic lumbar sympathectomy. The left side of the surgery is described in this video.

Results: Following surgery, the patient had dry and warm lower limbs. She was discharged after 24 hours of surgery. She had required only a single dose of parenteral NSAID analgesia. She developed mild parasthesia on the inner aspect of right thigh which was relieved by three months. At one year follow-up, she is still free from symptoms of plantar hyperhidrosis.

Conclusion: Retroperitoneoscopic bilateral lumbar sympathectomy is a safe and effective procedure in the treatment of plantar hyperhidrosis.