Hand sweating is a fairly common functional disorder in which the palms of the hands sweat excessively due to an unexplained overproduction of sweat glands. The sweat glands are controlled by the sympathetic nerves, and hand sweating is caused by an unexplained over-excitation of the sympathetic nerves, resulting in an abnormal increase in sweating on the palms of the hands. Although hand sweating is not a major health problem, sweating can cause a lot of inconvenience and embarrassment to life, work and social interactions. People with a tendency to sweat excessively have wet palms most of the time, and chronically wet hands often cause peeling. Teenagers of school age often get their exam papers wet due to excessive hand sweat, often before the papers are written. Teenagers are afraid to hold hands with others, and even shaking hands becomes a problem. In severe cases, the palms of the hands may even develop eczema dermatitis. As adults, they also cause inconvenience at work and social activities. These are not serious diseases, but excessive sweating puts patients in a daily state of helplessness, agitation or panic, causing great inconvenience to their work, social and life, and seriously affecting their self-confidence. The patient’s psychological pain is so great that it is difficult for ordinary people to understand. The treatment of hand sweating has long been a difficult problem. Non-surgical treatment (including astringents, antiperspirants, absorbents, sedatives, anticholinergic drugs, etc.) is not only ineffective, but also difficult to apply long-term because of its side effects; therefore, surgical treatment has become a major trend. The sympathetic nerve that controls the sweat glands in the hands is located in the second to fourth section of the thoracic spine (T2-4), which is about the line of the nipple and a little higher on both sides of the back vertebrae, and as long as this section of the thoracic sympathetic nerve is cut, the purpose of not sweating in the hands can be achieved. It is now recognized and proven that thoracic sympathectomy is the only effective and durable treatment for hand sweating to date. In the past, the supraclavicular approach required deep dissection from the neck, with poor exposure and the risk of potential injury to the brachial plexus, phrenic nerve, subclavian artery, vertebral artery and pleura; bilateral dissection was traumatic, leaving scarring, affecting function and aesthetics, and difficult for patients to accept. It has been replaced by minimally invasive thoracoscopic surgery for thoracic sympathectomy. The application of thoracoscopy has brought the treatment of hand sweating into a new historical period, as thoracoscopic surgery is less traumatic, better revealed, accurately positioned, safe and reliable, and quicker to recover after surgery, thus, eradicating hand sweating is no longer a difficult and unacceptable treatment. However, many hospitals and physicians who can perform thoracoscopic treatment for hand sweating now use three small triangular incisions (also called 3-hole thoracoscopy) on each side of the chest to place thoracoscopes and instruments to complete bilateral sympathectomy for hand sweating, and place a drainage tube in each of the two left and right chest cavities. Although this procedure is significantly less traumatic than traditional thoracotomy, there are still unattractive “plum triangles” (three small triangular-shaped incisions forming a scar) on both sides of the chest, and there is the trouble of postoperative placement of chest drains. Based on our rich experience in thoracoscopic treatment of hand sweating, we have made important improvements to the thoracic technique and are now treating hand sweating with a more advanced and minimally invasive procedure than ordinary thoracoscopy, referred to as single-hole minimally invasive thoracoscopic treatment of hand sweating; this procedure only requires a single tiny incision of 0.5-1.0 cm in the hidden area of the bilateral axillae, and through the micro-shaped thoracoscope and instruments, we can remove the bilateral T2 to T4 sympathetic nerves. The T2 to T4 sympathetic nerves can be removed through microscopic thoracoscopy and instruments. The single tiny incision in the hidden area of the axilla is treated with cosmetic sutures, and there is almost no scar after surgery. Moreover, the special technique used in the operation eliminates the need for chest drains and eliminates postoperative pain and scarring caused by chest drains. The surgery takes only 6 to 12 minutes on one side, with an average of 8 minutes. The results are immediate, and the hands are warm, dry and sweat-free after the operation, and all the worries and embarrassment caused by sweaty and wet hands in the past are gone immediately! The results are satisfactory and long-lasting. You can be discharged from the hospital the day after surgery, and the success rate of the treatment is as high as 95% to 99%.