Endoscopic thoracic sympathectomy
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.
Sympathectomy - endoscopic thoracic; ETC; Hyperhidrosis - endoscopic thoracic sympathectomy
You will receive general anesthesia before surgery. This will make you asleep and pain-free.
The surgery is usually done the following way:
After doing this procedure on one side of your body, the surgeon may do the same on the other side. The surgery takes about 1 to 3 hours.
Why the Procedure Is Performed
This surgery is usually done in people 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 and surgery in general are:
Risks for this procedure are:
Before the Procedure
Tell your surgeon or health care provider:
During the days before the surgery:
On the day of your surgery:
After the Procedure
Most people stay in the hospital one night and go home the next day. You may have pain for about a week or two. 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.
Follow the surgeon's instructions about taking care of the incisions, including:
Slowly resume your regular activities as you are able.
Keep follow-up visits with the surgeon. At these visits, the surgeon will check the incisions and see if the surgery was successful.
This surgery may improve the quality of life for most people. It does not work as well for people who have very heavy armpit sweating. Some people notice sweating in new places on the body, but this may go away on its own.
International Hyperhidrosis Society website. Endoscopic thoracic sympathectomy. www.sweathelp.org/hyperhidrosis-treatments/ets-surgery.html. Accessed April 3, 2019.
Langtry JAA. Hyperhidrosis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 109.
Miller DL, Miller MM. Surgical treatment of hyperhidrosis. In: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston and Spencer Surgery of the Chest. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 44.
Review Date: 3/12/2019
Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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