Surgical indications for television thoracoscopic surgery for hyperhidrosis In 2007, Kao MC [1] (2) et al. reported the application of sympathetic chain resection surgery for hand sweating. This was the earliest report on the use of sympathetic chain surgery for cephalofacial hyperhidrosis. In recent years, the use of sympathetic chain resection surgery for hand sweating has been reported abroad as well as in various parts of China. Most authors believe that there are no uniform criteria for the surgical indications for television thoracoscopic surgery for hand sweating, and most are based on the patient’s complaints of symptoms as the basis for diagnosis and treatment. It is considered that if the patient feels that excessive sweating is seriously affecting their normal life, often distressed and actively seeking treatment, and if the relevant investigations exclude secondary hyperhidrosis and neurosis caused by some underlying disease, hyperhidrosis can be diagnosed and can be an indication for surgery. Surgical approach The surgical position We generally use a semi-sitting supine position. The advantage is that intraoperative turning is no longer necessary, eliminating the need for re-sterilization and sheeting and saving time. The surgical field of view is clearly exposed, and the operation is easy and convenient. Generally, the operation can be completed within half an hour. After the surgery, the lung is expanded under the direct view of the thoracoscope, and after the lung is well reopened, a temporary chest tube is left in place and a water-sealed cup is connected, and the lung continues to be expanded until the residual air in the chest cavity is exhausted. After the surgery on one side is completed, the surgery on the opposite side is completed in the same way. This reduces surgical trauma, avoids the pain associated with closed chest drainage, reduces surgical trauma, and offers the possibility of shortening the patient’s hospital stay. The average postoperative hospital stay for patients was 2-3 days. Complications related to TV thoracoscopy for hand and foot hyperhidrosis The main complications reported in the literature, in addition to those common to TV thoracoscopy, are Horner’s syndrome, chancroid, and the rare occurrence of intraoperative cardiac arrest or postoperative severe bradycardia requiring pacemaker maintenance. The procedure has been performed in our department for nearly 8 years without appeal complications. We believe that the key to avoiding Horner’s syndrome is to accurately determine the site of sympathetic nerve dissection. The electrocoagulation time should not be too long to avoid damage to the stellate ganglion due to heat conduction. There is a high incidence of anhidrosis of the hands and feet and compensatory hyperhidrosis of other areas, but only a very small number of these patients cannot tolerate it. The postoperative results can meet the patient’s expectation and the patient is satisfied with the postoperative results. There was not a single case of serious intraoperative complication with intermediate open heart in our department, and no serious postoperative complication occurred. It proved that the surgical method is feasible and safe.