Summer is here, the weather is getting hotter, and everyone is sweating more and more, and for a group of people with hand sweating disorder, the arrival of summer marks the arrival of their breakdown day of the year. Hand sweating is a kind of uncontrollable restrictive hyperhidrosis caused by sympathetic overexcitation. Sweating is closely related to emotions, intensifies when it’s hot and stressful, and also in winter, when hands are often wet and cold, and may blister and peel. Many people have sweaty hands along with sweaty feet and armpits, and of course sweaty hands are numerous and predominant, which causes a great deal of distress in their daily lives. Many of the more severe hand sweating patients opt for surgery in order to treat their sweaty hands. So what is the past life of hand sweating surgery? Hand sweating surgery has been around for hundreds of years! In the old days, hand sweating surgery required a large incision in the chest, which took a long time and left a scar of about 10 cm after surgery. Not only was it unsightly, but the post-operative recovery was also slower. Since the 1980s, with the development of minimally invasive surgical techniques, hand sweating surgery has become a very tiny procedure. There has also been a greater understanding of sympathetic nerves. In the eighties, the T2, T3, and T4 sympathetic nerve segments would be cut at once to try to ensure that the hands did not sweat. It was later found that after this, the hand sweating resolved very precisely, but the head did not sweat either, with an 80-90% incidence of metastatic hyperhidrosis. This is more unpleasant than patients with hand sweating! In 2013, experts in the field started to cut T3, T4, or T3 or T4 alone. cutting T3 alone is very effective in resolving hand sweating, but there is still 1% of more severe metastatic sweating. The majority of people with T4 alone will be fine and have mild metastatic hyperhidrosis, but 1% of people may have ineffective or recurrent sweating. However, recurrence may be followed by reoperation to cut off T3. The annual Chinese Thoracic Surgery Conference held in June 2016 reached a consensus to recommend cutting off T4 in hand sweating to reduce the possibility of metastatic hyperhidrosis. If patients are not satisfied with the result of hand sweating they can have another surgery to cut off T3. because once metastatic hyperhidrosis occurs it is very difficult to solve! Nowadays, with the further development of medical technology, the surgery has evolved from cutting the nerve at the beginning to regulating the nerve as well, which not only greatly improves the success rate and safety, but also reduces the damage of the surgery to the human body.