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Endoscopic Thoracic Sympathectomy (ETS)


ETS is a last resort method of curing excessive sweating by effectively switching it off via at the nerves.

How Does It Work?

The cause of hyperhidrosis is not exactly known but what is known is that it has something to do with the sympathetic nervous system. A sympathectomy is a method of actually cutting nerves so that sweating can no longer be “switched on”.


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An endoscopic type or ETS is the most common method employed and involves less incisions and better recovery compared to older methods.

Typically, the entry incision is made via the armpit, regardless of where sweating occurs.

This type of surgery is never considered first for someone with a sweating problem. Even when surgical options are considered then liposuction to remove sweat glands is normally considered first because there is a lesser chance of side effects.

Controversy

ETS is highly controversial. Many doctors say that this type of surgery should not be performed. Yet at the same time, many surgeons say that it should.

The success rates from ETS vary and especially depend on the type of hyperhidrosis that is being treated. For instance, plantar hyperhidrosis does not respond well to ETS and only 30% of patients will get a good result. ETS is better suited to sweating of the hands, face and armpit. If it is performed for the feet then a non-standard procedure called a lumbar sympathectomy is required – this can lead to impotence for men and retrograde ejaculation (ejaculation into the bladder).

There are also said to be many side effects from ETS. A very common one is compensatory sweating. This is where the body decides to excrete more sweat from other parts of the body if it cannot sweat in the usual places due to ETS surgery. This type of sweating commonly happens on the trunk i.e. the chest and the back.

Anti-ETS Movement

So passionate do some people feel about this subject that there are even several anti-ETS movements on the internet.

If you are considering ETS then you would do best to get as many different views as possible in order to make your own balanced decision comparing the risks against the rewards.