Hand sweating is now commonly performed with minimally invasive small incisions and lumpectomy for T3-T4 sympathetic nerve chain dissection, with significantly reduced risk. After minimally invasive surgery has been performed, the impact and disturbance of cardiopulmonary function is significantly reduced. However, there are still risks when the procedure is performed bilaterally. In particular, when sequential selection is performed during surgery, the impact on the heart is significantly lower when right-sided sympathetic nerve chain dissection is performed first than when left-sided open sympathetic nerve chain dissection is performed first. Hand sweating surgery is a safer and more reliable procedure.