Endoscopic thoracic sympathectomy (ETS) is surgery to treat sweating that is much heavier than normal. This condition is called hyperhidrosis. Usually the surgery is used to treat sweating in the palms or face. The sympathetic nerves control sweating. The surgery cuts these nerves to the part of the body that sweats too much.
You will receive general anesthesia before surgery. This will make you asleep and pain-free.
Your surgeon will make 2 or 3 tiny surgical cuts under each arm.
After doing this procedure on one side of your body, the surgeon will do the same thing on the other side. The surgery takes about 1 to 3 hours.
This surgery is usually done in patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. It is only used when other treatments to reduce sweating have not worked.
Risks of anesthesia are:
Risks of surgery are:
Risks of this procedure are:
Surgeons who perform ETS must receive special training. Before having this surgery, make sure your surgeon has this training.
Tell your doctor or nurse:
During the days before the surgery:
On the day of your surgery:
Most people stay in the hospital 1 night and go home the next day. You may have pain for about a week. Take pain medicine as your doctor recommended. You may need acetaminophen (Tylenol) or prescription pain medicine. Do not drive if you are taking narcotic pain medicine.
Keep your surgical cut areas clean, dry, and covered with dressings (bandages). Wash the areas and change the dressings as your doctor told you to do. Do not soak in a bathtub or hot tub, or go swimming for about 2 weeks.
Slowly resume your regular activities as you are able.
Your doctor will ask you to schedule a follow-up visit to inspect your incisions and to see if the surgery was successful.
This surgery improves the quality of life for most patients. It does not work as well for people who have very heavy armpit sweating. Some people may notice new sweating, but this may go away on its own.
Sympathectomy - endoscopic thoracic; ETC
Boley TM, Belangee KN, Markwell S, Hazelrigg SR. The effect of thoracoscopic sympathectomy on quality of life and symptom management of hyperhidrosis. J Am Coll Surg. 2007;3:435-438.
Krasna, MJ. Thoracoscopic sympathetectomy. Thorac Surg Clin. 2010;20;323-330.
Updated by: Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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