Rush offers minimally invasive robotic endoscopic thoracic sympathectomy (ETS). This procedure is highly effective at treating hyperhidrosis and can help you find lasting relief from excessive sweating. Our thoracic surgery team specializes in safe, effective treatment for hyperhidrosis that improves your quality of life.
What Is Endoscopic Thoracic Sympathectomy?
Endoscopic thoracic sympathectomy, or ETS, is a procedure to reduce excessive sweating on your hands, arms or face. ETS is usually performed for hyperhidrosis, a condition that causes excessive sweating in these areas.
ETS is a minimally invasive robotic procedure performed using small incisions in your chest and a thin instrument called a thoracoscope. Your surgeon will cut some nerves in your sympathetic nervous system, which triggers your sweat glands. Cutting nerves that control the areas where you have hyperhidrosis symptoms can stop excessive sweating. ETS is also known as minimally invasive thoracic sympathectomy.
ETS is an outpatient procedure. Many patients are able to go home the same day, while others spend just one night in the hospital.
Conditions We Treat With ETS
ETS can treat conditions tied to overactive nerves, including:
- Hyperhidrosis, or excessive sweating, on your hands or underarms
- Certain cases of Raynaud’s phenomenon
Meet our endoscopic thoracic surgeons
How the Procedure Works
Endoscopic thoracic sympathectomy surgery is performed under general anesthesia, so you won’t feel any pain during the procedure.
After you are asleep, your ETS surgeon will make a few small cuts under your armpit. Then, they will put a thin tool with a camera on the end, called a thoracoscope, in one incision. Your surgeon will deflate your lung on the side being operated on to see your nerves better.
Then, your surgeon will insert other tools in the incisions to divide certain nerves in your chest. After, they will inflate your lung and close the small incisions. If you have excessive sweating on both sides of your body, the procedure will be repeated on the other side.
You rarely need a drainage tube placed in your chest after the surgery. ETS is usually completed in a few hours or less.
Benefits of Endoscopic Thoracic Sympathectomy
ETS can significantly reduce excessive sweating. For nearly all patients, the surgery eliminates hyperhidrosis symptoms of the hands and armpits. The procedure works quickly, with many patients noticing a reduction in excessive sweating right away. The results are usually permanent.
Endoscopic thoracic sympathectomy is a minimally invasive robotic surgery. This means you will have a shorter recovery time than if you had a large incision in your chest. You can usually return to your normal activities within a few days to weeks.
Is ETS Right for Me?
Doctors usually recommend ETS for patients who have already tried other hyperhidrosis treatments.
You may be a candidate for ETS if:
- You have excessive sweating on your hands, underarms or face
- Your hyperhidrosis is not caused by an underlying medical condition or medication you take
- Other treatments, like antiperspirants, oral medications and Botox injections haven’t worked for you
- Sweating interferes with your daily life
- You can receive general anesthesia
Risks and Considerations of ETS Surgery
As with any surgery, there are some risks and side effects associated with ETS, including:
- Compensatory sweating: You may sweat more on your back, abdomen and legs after this surgery. Compensatory sweating is the most common side effect associated with ETS. However, most of the time, this resolves on its own over the course of a few months
- Chest discomfort: You will likely feel some pain following surgery. The incision sites will take a few weeks to fully heal.
- Horner’s syndrome: This is a rare side effect of ETS. Patients with Horner’s syndrome have drooping eyelids and other facial symptoms.
- Dry skin: Some patients may have dry skin on their face after ETS.
Choosing Rush for ETS Surgery
- Among the best in the U.S.: U.S. News & World Report ranks Rush University Medical Center among the best hospitals in the nation for pulmonology and lung surgery.
- Minimally invasive excellence: Our thoracic surgeons are highly skilled in minimally invasive techniques and experienced in performing ETS. Rush University Medical Center performs more video-assisted thoracoscopic surgeries, a minimally invasive technique, than any other hospital in Illinois.
- Close to home: Rush thoracic surgeons provide care in Chicago and at several suburban locations. If you have surgery in Chicago, you can schedule follow-up care where it’s convenient for you.
Endoscopic Thoracic Sympathectomy (ETS) FAQs
If excessive sweating is limiting your quality of life, you may be a candidate for ETS surgery. Your doctor may recommend surgery if other treatments you’ve tried for hyperhidrosis have not worked.
After ETS, you may sweat more on other parts of your body, including your chest, back and legs. This is called compensatory sweating. Most patients have some compensatory sweating after ETS, even if it is mild. Rarely, patients have severe compensatory sweating. This sweating will usually resolve on its own.
You will likely be able to go home shortly after surgery. Most patients feel some pain after surgery, which can be managed with over-the-counter medicine, or medications prescribed by your doctor. You will likely be able to resume your normal activity within a few days to weeks.
Many insurers cover ETS surgery. Your insurer may require you to try other treatments for your hyperhidrosis before covering surgery. Check with your insurance company to make sure the Rush provider you plan to visit is included in your network.
The most common side effect of ETS surgery is compensatory sweating. Some rare complications can happen after ETS, drooping eyelids and compensatory sweating.
Many patients experience immediate improvement of their hyperhidrosis symptoms after ETS surgery.