Dr. Reisfeld published a peer-reviewed study in The American Surgeon evaluating endoscopic lumbar sympathectomy as a treatment for severe plantar hyperhidrosis — covering 154 patients and 308 bilateral surgical procedures. Results were analyzed with the assistance of a statistician, and the procedure was performed by a team of two surgeons, reflecting the technical complexity of working behind the abdominal cavity to access the lumbar sympathetic chain.
Severe foot sweating accompanies severe hand sweating in most cases. After non-surgical treatments failed, lumbar sympathectomy was developed and refined over several years into a fully bilateral outpatient procedure. The success rate reached 99.2% — and postoperative pain was considerably less than that reported for endoscopic thoracic sympathectomy. An additional benefit observed was improvement in buttocks and groin sweating that had resulted from prior thoracic sympathectomy.
This operation presents a challenge due to the fact that it is not done in the abdominal cavity — the surgeon creates a space behind the abdomen to locate the lumbar sympathetic chain to clamp or cut it. The success rate is very high at 99.2%.Dr. Rafael Reisfeld, The American Surgeon, 2013