Emory Hyperhidrosis Center

State of the art treatment and high success rates

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Overview

Co-directed by Dr. Daniel Miller and Dr. Suephy Chen, the Emory Hyperhidrosis Center in Atlanta is a multi-disciplinary program staffed by dermatological specialists and general thoracic surgeons that offers minimally invasive surgery as well as medical, non-surgical methods for treating hyperhidrosis. Part of the only comprehensive Minimally Invasive Thoracic Surgery Center in the southeastern United States, the Hyperhidrosis Center is one of the few programs in the country and the only service in Georgia to offer thoracoscopic sympathectomy, an outpatient procedure that relies on small incisions aided by tiny cameras and specialized surgical instruments.

Non-Surgical Treatment

Depending on the severity of the condition and the patient's overall physical health, the conservative, non-surgical approach may be recommended by center physicians. Also, patients new to treatment may wish to gauge the potential benefits of the following methods:

• Prescription antiperspirants
• Iontophoresis (the delivery of low currents of electricity to the hands or feet while they are submerged in water)
• Medication therapy
• Botox injections

Surgical Treatment: Thoracoscopic Sympathectomy

Covered by many insurance companies after the failure of non-surgical methods, thoracoscopic sympathectomy typically takes less than 30 minutes, involves no stitches and yields excellent success rates. Dr. Miller and Dr. Seth Force, the only surgeons currently performing the procedure in Georgia, have achieved success rates of 99% for the hands, 90% for the armpits and 70-85% for the feet.

As a fellow in thoracic and cardiovascular surgery, Dr. Miller did the first thoracoscopic surgery ever performed at the Mayo Clinic in 1991. During his later years as a Mayo faculty surgeon he focused on refining thoracoscopic surgery for hyperhidrosis. When he arrived at Emory in 2002, Dr. Miller had significantly adapted and refined the basic components of the procedure and began referring to it as microthoracoscopic sympathectomy (MTS), the method of choice for him and Dr. Force.

Primary stages of thoracoscopic sympathectomy:

• With the patient under general anesthesia, the surgeon makes an incision in the armpit
• A 3-mm thoracoscope is inserted into the chest cavity
• The surgeon identifies the sympathetic nerve along the ribs in the back of the chest, then either divides it over the second rib for palmar hyperhidrosis (excessive sweating of the palms), over the third rib for axillary hyperhidrosis (armpits) or over both ribs for patients with both types of the condition
• The procedure is then duplicated on the other side of the chest

Dr. Miller's innovations to the procedure:

• The surgeon makes only one incision for each side of the chest rather than three
• The incisions are 4-mm rather than the standard 10-mm
• The lungs are compressed with carbon dioxide rather than collapsed
• Chest tubes are avoided

Patient/Physician Contact

There are two options for prospective patients to schedule an initial consultation regarding medical or surgical hyperhidrosis treatment:

• Contact the General Thoracic Surgery Center clinical office at 404-778-3593.
• Contact Emory HealthConnection^SM at 404-778-7777 or 1-800-75-EMORY (1-800-753-6679). HealthConnection^SM offers immediate access to information on Emory services and physicians.

Referring physicians also have two options:

• Contact the General Thoracic Surgery Center clinical office at 404-778-3593.
• Call the Emory Physician Consult Line at 404-778-5050 or 1-800-22-EMORY (1-800-223-6679). For more information about referring a patient to Emory, click here.

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