Hyperhidrosis is a disease in which the sympathetic nerves are overexcited and cause excessive sweating. Under normal circumstances, the sympathetic nerve regulates body temperature by controlling sweating and heat dissipation, but in patients with hyperhidrosis, sweating and facial flushing are completely out of control, leaving the patient in a state of helplessness, agitation or panic. There are two types of symptoms: generalized and restricted hyperhidrosis. In generalized hyperhidrosis, the skin surface is often moist and there are bouts of sweating. Localized hyperhidrosis is common in the palms of the hands, feet and plantars, axillae, followed by the tip of the nose, forehead, pubic area, etc. It mostly develops in adolescence, and patients are often accompanied by peripheral blood circulation dysfunction, such as wet and cold, bruised or pale skin on the hands and feet, and susceptibility to frostbite. Sweaty feet due to poor evaporation of sweat, resulting in impregnation of the epidermis of the soles of the feet and white, often accompanied by foot odor. When the armpits and pubic area sweat a lot, because the skin is thin and tender, often moist friction, prone to rubbing red spots, accompanied by folliculitis, boils, etc. The palms of the hands sweat too much, hands are too wet and dare not shake hands with others, even when writing will be too much water on the hands and stain the paper; feet sweat often make socks, insoles wet, can feel the bottom of the feet will slip when walking, and even too much sweat impregnated skin, making the skin white, between the toes erosion, often lead to fungal, bacterial breeding, causing foot odor, ringworm, etc.; axillary sweating can be seen sweat from the armpits down to drip, clothes The clothes are often soaked with sweat. When bacteria invade the infection, the armpit can not only emit an unpleasant smell (i.e., armpit odor), but also complicate skin inflammation. The pathology is due to excessive secretion of small sweat glands, which is manifested by abnormal excessive sweating either generalized (generalized hyperhidrosis) or localized (restricted hyperhidrosis). Primary hyperhidrosis is of unknown etiology and occurs most frequently in the palms, armpits and soles of the feet, and occasionally in the head, neck, trunk and lower legs. The onset of hyperhidrosis usually begins at a young age and worsens in adolescence and remains with the patient for life. When the condition is severe, it not only affects the patient’s work, life and study, but can even cause psychological disorders and make the patient afraid to participate in normal social interactions. In 2004, John Hornberger of the American Academy of Dermatology organized a collaborative group of experts from more than 20 units to develop a diagnostic reference standard. The diagnosis is confirmed if the hyperhidrosis has been visible to the naked eye for at least 6 months without apparent cause and if two of the following conditions are met: (1) Bilateral symmetry of sweating areas. (2) At least one episode a week. (3) Age of onset is less than 25 years. (4) Positive family history. (5) No excessive sweating during sleep. (6) Interference with daily work life. The presence of secondary hyperhidrosis should be noted if accompanied by fever, night sweats, and weight loss. Treatment Although there are many treatments, they are often ineffective, including astringents, antiperspirants, sedatives, hypnotherapy, psychotherapy, iontophoresis, and acupuncture. Thoracic sympathetic ganglion or sympathetic nerve trunk dissection is the only effective and long-lasting treatment for hyperhidrosis, but in the past, bilateral open-chest surgery was very traumatic and the incision scars affected function and aesthetics, which was often difficult for patients to accept. At present, the TV thoracoscopic thoracic sympathetic nerve trunk dissection carried out in thoracic surgery is less traumatic, well exposed, accurately positioned, safe and reliable, with fast postoperative recovery and satisfactory and long-lasting efficacy, and can complete bilateral surgery at the same time, which patients are happy to accept. In conclusion, TV thoracoscopic thoracic sympathetic nerve trunk dissection is the safest and most effective treatment for hyperhidrosis at present.