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, anxiety 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 very 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 nipple line, and then 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 long-lasting 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, well exposed, accurately positioned, safe and reliable, and quick to recover after surgery, thus, eradicating hand sweating is no longer a difficult and unacceptable treatment. However, many hospitals and physicians are now able to carry out thoracoscopic treatment of hand sweating, using three small triangular incisions (also known as 3-hole thoracoscopy) in each side of the chest, respectively, to place the thoracoscope and instruments to complete bilateral sympathectomy for hand sweating, and place a drainage tube in each of the left and right sides of the chest. 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. Our thoracic surgery department has made important improvements to the thoracic technique based on our rich experience in using thoracoscopy to treat hand sweating, and now we are using a more advanced and minimally invasive procedure than ordinary thoracoscopy to treat hand sweating, referred to as single-hole minimally invasive thoracoscopy to treat hand sweating; this procedure only requires a single tiny incision of about 0.5-1.0 cm in the hidden area of bilateral axillae, and through the micro-shaped thoracoscope and instruments, we can remove bilateral 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 effect is satisfactory and long-lasting. You can be discharged from the hospital the day after surgery, and the success rate of treatment is as high as 95% to 99%.