Monday, June 18, 2007

Sweaty Palm Surgery

Bilateral Video Assissted Thoracoscopic Sympathectomy

Surgeon: Mr Hj Isham
Anaesthetist: Dr Hj Zulaidi

Indication: Palmar hyperhidrosis

Good News for those suffering from excessive sweating especially in the palms and axilla, a new surgical technique that reduces this troublesome symptom has recently been undertaken at RIPAS hospital and proven to be a success. Mr Hj Isham Hj Jaafar, our very own Cardiothoracic Surgeon demonstrated this technique where via three small holes (10 mm each) a camera and 2 instruments was inserted through the axilla to gain access to the sympathetic chain which supplies the sweat glands. The Anaesthestist involved Dr Hj Zulaidi Hj Abd Latif then provided an excellent view of the chain by collapsing one lung at a time using a special Endotracheal Tube which allows the main bronchus to be blocked. This anaesthetic manouvre required endoscopic equipment which was also vital for a successful surgery.

The 1st patient in Brunei to ever receive this treatment was a 31 year old businessman who had been suffering from Palmar Hyperhidrosis for the last 13 years and has been waiting for this surgery for 3 years. He said he sweats even in the coldest environment and is exacerbated during anxious situations. The symptoms can get so bad that his hand dribbles in sweat and shaking people’s hand become something that he would rather avoid. This is extremely difficult for a businessman who meets new and important clients on a regular basis.

The surgery had certainly given him an extra confidence and he now looks forward to shake peoples hands.


Dr Hj Zulaidi & Mr Hj Isham

Wednesday, June 13, 2007

Alternative to Viagra!

Royal College of Surgeons England MRCS Part 3 Preparatory Course

A Bloated Tummy

65 year old man presented to casualty with a 3 days history of colicky abdominal pain, vomitting and distended abdomen. Whats your diagnosis and what would you propose the treatment.