Endoscopic Thoracic Sympathectomy

Endoscopic Thoracic Sympathectomy

Endoscopic thoracic sympathectomy (ETS) is a surgical operation where certain segments of the sympathetic nerve will be cut or destroyed. These nerves are situated in the chest cavity adjacent to the spine. ETS surgery is utilized to treat sweating that’s much heavier than normal (hyperhidrosis), facial blushing, Raynaud’s disease and reflex sympathetic dystrophy.

Endoscopic thoracic sympathectomy is looked upon the treatment of choice, having minimum morbidity and high initial success rates. The surgery is performed on an outpatient basis and surgeons who perform endoscopic thoracic sympathectomy operations must obtain special training.

It’s only utilized when other treatments haven’t worked. The most common disorder treated with ETS surgery is palmar hyperhidrosis, or as it’s most commonly known as “sweaty palms“. With palmar hyperhidrosis, the palms may constantly produce so much perspiration that the affected individual is not able to hold paper, documents without getting them wet, keep garments dry while wearing them, or shake hands. The resulting effect is oftentimes a distressing and often socially disabling condition to the individual. Various studies has shown that about 2/3 of the patients have had some family history for hyperhidrosis.

The surgical process is performed under general anesthesia. This will render you unconscious and incapable of feeling any pain of the surgery. Your operating surgeon will make 2 or 3 small incisions under one of your arms. Sympathectomy physically destroys some tissue anywhere in either of the two sympathetic trunks, which are long chains of nerve ganglia lying along either side of the spine. Each nerve trunk is broadly divided into three regions: cervical (neck), thoracic (chest), and lumbar (lower back).

The more common area targeted in sympathectomy is the upper thoracic region, that part of the sympathetic chain lying between the first and fifth thoracic vertebrae. After doing this procedure on one side of your body, your surgeon will do the same thing on the other side. The surgical process takes approximately 1 hour in total (takes about 30 minutes on each side) and regular physical activity and returning to work are possible inside a week or less.

Scars are minimal and out of sight. A sharp decrease in perspiration is instantly noticed by the patient upon awakening from the operation. You may experience pain for about a week. Keep your surgical incisions area clean, dry, and covered up with fresh dressings. Wash the areas and change the dressings as your physician told you to.

Don’t soak in a bathtub, or go for a swim, for about 2 weeks. Your MD will ask you to schedule a follow-up visit to inspect your surgical incisions and to see if the surgery was successful. ETS surgery betters the quality of life for most patients, but it doesn’t work as good for folks who have very heavy armpit perspiration. Some folks may discover new sweating, but this may go away on its own.

In addition to the normal risks of surgery, such as bleeding and infection, sympathectomy has several specific risks:

Risks for this procedure are:

• Adverse changes in how nerves function
• Damage to arteries or nerves
• Increased or new sweating
• Horner syndrome (decreased facial sweating and drooping eyelids)
• Pneumothorax or lung collapse