Endoscopic Thoracic Sympathectomy

Hyperhidrosis is characterized by abnormal, excessive sweating that can occur in the hands, armpits and feet. For some, the abundant sweating is localized to one area, such as the hands, while others may experience increased sweating in a combination of areas.

The only treatment with proven long-term results involves surgical interruption of the sympathetic chain. These nerves primarily affect blood flow to the skin and the function of the sweat glands. Interrupting the sympathetic nerves in the chest results in dilation of the veins and arteries in the arm and hand as well as the complete blockage of sweating.

Endoscopic Thoracic Sympathectomy (ETS)

Recently, a minimally invasive procedure called endoscopic thoracic sympathectomy (ETS) was developed to treat hyperhidrosis. Using very small incisions, the sympathetic chain is cut or clamped to eliminate the excessive sympathetic nerve activity. Using this approach, the procedure may be done on an outpatient basis with quicker recovery and less scarring than open surgery. The procedure is highly effective in eliminating excessive sweating of the hands in over 98 percent of patients. In addition, the risk of complication is very low. ETS also can be applied in selected patients with axillary hyperhidrosis, or excessiving sweating of the armpits.

Thoracic surgeons at UCSF Medical Center have significant experience in the treatment of hyperhidrosis using ETS. We can perform ETS on both sides of the body during a single operation if needed. The operation requires general anesthesia, and two 5 millimeter incisions on each side. Most patients leave the hospital in under 24 hours and their recovery is generally complete within two weeks.