Endoscopic thoracic sympathectomy


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


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.

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.

Why the Procedure Is Performed

This surgery is usually done in patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. It is only used when other treatments to reduce sweating have not worked.


Risks for any anesthesia are:

Risks for any surgery are:

Risks for this procedure are:

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

Before the Procedure

Always tell your doctor or nurse:

During the days before the surgery:

On the day of your surgery:

Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

Most people stay in the hospital 1 night and go home the next day. You may have pain for about a week. Take pain medicine as your doctor recommended. You may need acetaminophen (Tylenol) or prescription pain medicine. Do not drive if you are taking narcotic pain medicine.

Keep your surgical cut areas clean, dry, and covered with dressings (bandages). Wash the areas and change the dressings as your doctor told you to do. Do not soak in a bathtub or hot tub, or go swimming for about 2 weeks.

Slowly resume your regular activities as you are able.

Your doctor will ask you to schedule a follow-up visit to inspect your incisions and to see if the surgery was successful.

Outlook (Prognosis)

This surgery improves the quality of life for most patients. It does not work as well for people who have very heavy armpit sweating. Some people may notice new sweating, but this may go away on its own.


Boley TM, Belangee KN, Markwell S, Hazelrigg SR. The Effect of Thoracoscopic Sympathectomy on Quality of Life and Symptom Management of Hyperhidrosis. Journal of the American College of Surgeons. March 2007;204(3).

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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