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Endoscopic thoracic sympathectomy

Definition

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.

Alternative Names

Sympathectomy - endoscopic thoracic; ETC

Description

You will receive general anesthesia before surgery. This will make you unconscious and unable to feel pain.

Your surgeon will make 2 or 3 tiny incisions (cuts) under one of your arms.

• Your lung on this side will be deflated (collapsed) so that air will not move in an 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 incisions.
• Using these tools, your surgeon will locate 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 incisions with sutures (stitches).

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 hour total.

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Infection
• Heart attack or stroke during surgery

Risks for this procedure are:

• Damage to arteries or nerves
• Increased or new sweating
• Horner syndrome (decreased facial sweating and drooping eyelids)

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

Review Date: 2/17/2009
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.