Introduction: Since its first description by Kux in 1954, the thoracic endoscopic (thoracoscopic) sympathectomy has rendered the open techniques obsolete in the treatment of the hyperhidrosis and other sympathetic-related diseases. Aim: The goal of this article is to present a critical review of the current indications, results and complications of the endoscopic thoracic sympathectomy. Material and methods: An extensive search and review of published papers on the thoracoscopic sympathectomy was undertaken. Results: The thoracoscopic sympathectomy has evolved as a therapeutic choice in patients with focal hyperhidrosis, pain syndromes and peripheral vascular disorders, particularly. The results, recurrences and complications are similar to the previously established open procedures; nevertheless, the morbidity, the hospital stay and the time to return to activities of daily living are substantially reduced. The highest success and satisfaction rates (over 95%) were observed among patients treated for focal hyperhidrosis. Conclusions: The success and complication rates of thoracoscopic sympathectomy are comparable to those of open techniques, with an easier postoperative period and an earlier return to labor and daily living.
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