Robotic Treatment of Hyperhidrosis, Including Nerve Reconstruction for Prior Surgery

Surgery isn't just about surgeon skill, it also depends on OT infrastructure and trained technical staff, and not everything required can be exported to run a camp abroad. A more practical model already in use is a structured online OPD: patient details and reports are shared in advance on an agreed schedule, and the African doctor partner, the Jivo team, and the Indian specialist jointly review the case and decide what can be treated locally versus what genuinely needs travel to India, with real patient satisfaction from this approach so far.

A large number of patients from various African countries have been treated, most commonly for bronchiectasis and various tumours of the lung and chest cavity, even without ever having personally visited Africa. For heart transplantation specifically, deceased-donor transplant is not possible for international patients under Indian law, so the more common referral for advanced heart failure from abroad is for an LVAD (left ventricular assist device), which has very good outcomes and has itself reduced overall demand for heart transplant.

Deceased-donor lung transplantation is not possible for international patients in India under current law, but in general, outcomes vary significantly by the underlying pathology, results are good for pulmonary hypertension, while outcomes for cystic fibrosis, bronchiectasis and other conditions vary by the individual disease process rather than following one single success rate.

After empyema surgery in young patients, both a visceral and parietal decortication are performed, and dense adhesions do form afterward, that is simply the nature of the disease and the aim of surgery is to release the lung and prevent fibrothorax, not to avoid adhesions altogether. Lung transplantation after pulmonary tuberculosis is very challenging, particularly if the patient has already developed fibrothorax; a unilateral transplant may be possible in some cases, but it depends entirely on the individual patient and no generalised statement can be made. Deceased-donor lung transplant is also not available to international patients under Indian law, which permits only living donors.

The robotic platform's vision is excellent, so nerves that are difficult to identify by standard VATS are very clearly seen with the robotic system, and it also allows much finer dissection. These sensitive structures are therefore better identified and better protected specifically because of the robotic system's magnified 3D vision and precise instrument control.

Only patients with high-grade hyperhidrosis, where the hands are literally dripping, after all non-surgical options, oral medication, local treatment, creams and Botox, have been tried and failed. It should never be offered as a first-line treatment.

Yes, through robotic sympathetic nerve reconstruction, using the patient's own intercostal nerve to reconnect the cut ends of the sympathetic chain with interrupted sutures. Patients have reported significant quality-of-life improvement roughly eight to nine months after the procedure.