Endoscopic thoracic sympathectomy

Alternative Names: Sympathectomy - endoscopic thoracic; ETC

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 surgery stops or turns off the nerve signals that tell the part of the body to sweat too much.

Description of Procedure

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.

• Your lung on this side will be deflated (collapsed) so that air will not move in and out of it during surgery. This gives your surgeon more room to work.
• A tiny camera called an endoscope will be inserted into your chest. Video from the camera will show on a monitor in the operating room. Your surgeon will use the monitor to do your surgery.
• Your surgeon will insert other small tools through the other cuts.
• Using these tools, your surgeon will find the nerves that control sweating in the problem area. These will be cut or destroyed.
• Your lung on this side will be inflated.
• Your surgeon will close your cuts with sutures (stitches).
• A small drainage tube may be left in your chest for 1 day

After doing this procedure on one side of your body, your surgeon will do the same thing on the other side. The surgery takes about 1 - 3 hours.

Risks of Endoscopic thoracic sympathectomy

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Heart attack or stroke during surgery
• Infection

Risks for this procedure are:

• Blood collection in the chest (hemothorax)
• Damage to arteries or nerves
• Horner syndrome (decreased facial sweating and drooping eyelids)
• Increased or new sweating
• Increased sweating in other areas of the body (compensatory sweating)

Surgeons who perform ETS must receive special training. Before having this surgery, make sure your surgeon has this training.

Review Date: 1/26/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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