1, the incidence of hyperhidrosis and the impact on the quality of life of the population Hyperhidrosis, especially in exposed parts of the body, such as hands, armpits and head and face of the obvious sweating seriously affects the normal life of many people. In fact, it is often a pathological condition, medically referred to as “hand sweating”, “cephalic hyperhidrosis” or “axillary sweating”. It seriously affects the quality of life of this group of people. Due to nervousness or noisy head and face sweating and do not dare to show their faces in public social occasions, do not dare to go on stage to give a speech; due to the serious sweaty palms and do not dare to shake hands with others, or shy to hold hands with lovers; armpit sweating wet clothing so that the young girls embarrassed; writing sweat wet paper; operation of the computer when the sweat wet keyboard; …… where all of these are This kind of friend’s plight. It can be said that because of these exposed parts of the sweat seriously affects their emotions, socialization, career choice and even marriage. Especially in recent years, with the improvement of people’s living standards and quality of life requirements, the number of people who have taken the initiative to seek treatment for this condition is high. There are no exact statistics on the incidence of hyperhidrosis in the Chinese population. A foreign population statistics show that the incidence of hyperhidrosis in various parts of various degrees is 6‰-10‰. Among them, 1/4, i.e. 1.5‰-2.5‰ are sweaty hands. There are 40% of hyperhidrosis patients have genetic predisposition. 2, the traditional treatment of hyperhidrosis, unless there is a clear underlying disease, such as hyperthyroidism, obesity and neurosis can be accompanied by excessive sweating, most cases of hyperhidrosis are no clear cause, so also known as “primary hyperhidrosis”. Since the pathogenesis of hyperhidrosis is unknown, there are various treatment methods for hyperhidrosis. Traditional treatments include biofeedback, hypnosis, psychotherapy, sedation, anticholinergic receptor medication, traditional Chinese medicine, topical astringent treatment or radiation therapy for sweating areas, etc. However, all of these treatments do not have a clear cause. But all of these treatments are not very sure of the therapeutic effect. Because of the long-term treatment effect is not ideal, so that many people have fear of this disease and all kinds of incorrect interpretation. Some people think that it is a genetic problem, so can not be treated; some people think that this represents their own body “weak”, and therefore consume a lot of “supplements”, but in the end is basically no help; there are also some people think that because of their own introverted personality, timid Some people think it is because of their introverted character, timid, so there will be to the speaker’s platform or other public occasions when sweating profusely. Whether this view is correct or not, but it does add to the psychological burden of these sweating friends. 3, the history of sympathetic nerve chain excision (cut off) surgical method and the status of domestic and international application of sympathetic nerve chain excision surgery for the treatment of hand sweating this method first appeared in 1920. Due to the special anatomical location of this structure, at that time, only open thoracic surgery can be used to complete this surgery, the surgical trauma is obviously very large. Therefore, this method was not widely accepted by patients and doctors at that time. However, since such an operation to remove the sympathetic nerve chain was indeed able to treat excessive sweating of the hands with certainty, people did not give up on this operation, but have since begun to improve it and make it more minimally invasive. Successive surgical methods have been invented, such as supraclavicular incision, dorsal paraspinal incision, axillary incision, etc., but none of them have significantly reduced the trauma of the surgery, and on the contrary, they have increased a series of possible surgical complications. It has also been proposed to treat hand sweating by destroying the sympathetic chain through extracorporeal injections of specific drugs. Although such means are indeed much less invasive, an important problem is that the efficacy of the treatment is very uncertain, because it is difficult to accurately reach the expected ganglionic segments by extracorporeal puncture. The advent of television thoracoscopy in the 1990s gave a light in the darkness to the exploration of this surgical approach. It is a modern medical technology based on television imaging and cold light technology. Through a small incision of 0.5 cm in the chest wall and a TV thoracoscope inserted in it, the surgeon can clearly see the sympathetic nerve chain located next to the spine, and then through another small incision of the same size and some special instruments, the surgeon can perform the surgery of removing or cutting the sympathetic nerve chain. The technical simplicity of this procedure, made possible by modern technology, has led to a tens or even hundreds of cases of this procedure being performed all over the world in the last 10 years or so. In the last few years, hundreds of articles have been published in the international literature on this procedure every year, involving tens of thousands of cases. The use of televised thoracoscopic techniques has made this procedure a truly mature and routinely performed diagnostic and therapeutic technique. Along with the minimally invasive improvement of the surgical approach, the indications for the procedure and the technical details of the procedure have also changed. For example, it was previously thought that this surgery could only treat hand sweating, but now it has been found that axillary sweating, head and face hyperhidrosis, Raynaud’s syndrome of the upper extremities, and long QT syndrome can also be treated with this surgery. In the past, it was thought that the sympathetic nerve chain had to be removed from a certain segment in order to achieve treatment, but now it has been found that severing the nerve chain at a specific location can also achieve the same goal. In addition, the cut-off surgery has completely replaced the resection surgery as the standard procedure. In China, several large treatment centers have made a series of in-depth studies on this surgery and the structure and function of the sympathetic nerve chain, which have received the attention of international scholars and have greatly ensured the safety and effectiveness of clinical surgery. Some units with less experience in thoracoscopic surgery are also trying to carry out this kind of surgery, which is still to be standardized technically, especially in the aspect of avoiding surgical complications, and needs some in-depth theoretical knowledge as technical support. 4.Basic method of TV thoracoscopic sympathetic chain severance surgery and related problems in diagnosis and treatment The patient needs to be hospitalized for 3-4 days, and some necessary examinations (blood routine, liver and kidney function, coagulation function, electrocardiogram, chest radiographs, etc., which is equivalent to a systematic physical examination) are done before the surgery. The surgery is performed under general anesthesia. A small incision of 5-10mm is made in a hidden location under the armpit, and a thoracoscope is placed in, so that the doctor can see the inside of the thoracic cavity as well as the sympathetic chain of nerves that is located next to and parallel to the spine through a TV screen. With the help of special instruments, the surgeon can cut the sympathetic nerve chain in less than 5 minutes. After the operation on one side, the other side is operated in the same way. The total operation time is less than half an hour. The patient can go down to the ground in the afternoon of the day after the operation. The patient is discharged from the hospital the next day, and can return to work in 2-3 days, with little scarring on the chest wall after the stitches are removed. Even if there are some scars, they will not affect the aesthetics because they are located in a hidden position like the armpit. 5, the effectiveness of the operation, safety and possible complications: hand sweating can reach 98% -100% improvement rate, head and face hyperhidrosis improvement rate of more than 90%, axillary sweating rate of 75-80%. The surgery is very minimally invasive and generally safe. There are some long-term side effects of the surgery, the most common being compensatory sweating in other parts of the body, which is now a very rare complication in experienced centers, and the symptoms are very mild. In addition, a small percentage of patients may experience a slight slowing of the surgical heart rate, but this does not usually interfere with normal life or physical activity. Part of the patient’s surgical hands too little sweat and chapped, sometimes need to rub some skin care oil. 6, social and medical factors affecting people to choose this surgery Although this surgery from the 1920s has appeared, but historically not widely used, mainly due to excessive trauma. 1990s since the report of this surgery is more and more, more and more people accept this surgery, this is the TV thoracoscopy technology from the fundamental solution to the problem of surgical trauma is also the result of the improvement of the quality of life requirements of the people. This is a result of the fundamental solution to the problem of surgical trauma by TV thoracoscopic technology and of people’s increased demands on their quality of life. Even so, there are still many people suffering from excessive sweating who cannot undergo such surgery in time. There are a number of social and medical factors involved. (1) Due to the influence of traditional concepts, many people do not realize that excessive sweating of the hands and head and face is a separate condition that can be completely treated, so they have been “suffering in silence” for a long time without going to the clinic for treatment. (2) Many patients suffering from hand sweating or excessive sweating of the head and face do not know which department to go to for treatment, often the first thing that comes to mind is dermatology, neurology, or internal medicine, and doctors in these departments often do not know that the sympathetic chain cut off this surgery, making this part of the patient is not able to get timely and accurate treatment. (3) Thoracic surgery thoracoscopic surgeon is a competent doctor to carry out this surgery, the doctor thoracoscopic surgery experience is to ensure the safety of the operation, affecting the success or failure of the operation of the key. However, most patients, even if they are aware of this procedure, do not realize that they should seek treatment for diseases such as hand sweating and cephalic sweating from a thoracic surgeon.