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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 sympathetic nerves control sweating. The surgery cuts these nerves to the part of the body that sweats too much.Click here to watch a clinical video
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The Endoscopic thoracic sympathectomy or sympathectomy refers to a surgery used to treat an abnormally high sweating condition called hyperhidrosis. Usually, this operation targets sweating in the palms, hands, armpit or the face area by cutting the sympathetic nerves to the part of the body that is sweating too much. It’s the sympathetic nerves which control the sweat glands of the armpit and hands and are positioned inside the rib cage near the top of the chest. The autonomic nervous system controls the sweating in our body. We do not really have any conscious control over this condition. Hyperhidrosis is often considered to be the response of the central nervous system to emotional stress resulting in abnormal sweating. But at times, it can also occur without stress.
1. What is the procedure?
The Laparoscopic Endoscopic thoracic sympathectomy surgery consists of a few simple steps, as described below:
- The surgeon makes a tiny incision below the armpit
- One or two other incisions may be made as well
- The lung (on the side where the patient is being operated upon) is subsided a little so that the surgeon gets better room for carrying out the operation--- while the other lung is good enough to carry out all the normal functions
- A camera, attached to a thin telescope is inserted through the first incision (mentioned above)
- Other instruments to divide the nerves, are put through the second or third hole
- Now the nerves are cut
- The deflated lung is now re-expanded to carry on normal functions
The laparoscopic approach to surgery has several benefits:
- It is very effective for stopping sweating in hands and a little less (nonetheless, sufficiently) effective in treating armpit sweating
- Very short hospital stay
3. Appropriate For
Though it’s always your surgeon whether, at all, you’re appropriate for this surgery or not, you might consider talking to him if:
- Simple measures like antiperspirants or iontophoresis (a process which involves the passing of electric currents across the skin) have not worked
- Your hands and armpits are particularly sweaty
- The sweating is excessive
You can undergo this surgery only if you have general good health.
4. Before surgery
Before your surgery your physician will hold thorough discussion with you regarding its risks and complications. A chest x-ray would be done. Other medical tests might be done as well- if the physician feels the need for the same. Please provide your complete medical history to your surgeon. You might be asked to give up smoking and exercise properly. Get good sleep as well. You will not be allowed to eat or drink anything immediately before the surgery.
This surgery is conducted mostly for outpatients, which means you might not be required to stay back for an overnight stay at the hospital. You may return to work within a week. As per reports this surgery can cure hyperhidrosis in around 90% cases.
6. After care
Your surgeon will inform you about the specific after care which will be needed after you’ve had the operation. A test called Doppler ultrasonography might be performed in order to see if the operation has had a positive effect or not.
7. Risk & complications
There are several complications of the Laparoscopic ETS Surgery as well. Risks may include a fall in pressure causing you to faint, chest injury, deep breathing or chest pain.
The lesser invasive surgery results in better cosmetic healing and complete cure of sweating. There are chances of severe compensatory sweating in other parts of the body after the surgery, but only 1 in 100 people might experience that.
9. What next
You might as well be able to bounce back to normal life within a week or so. Do consult your surgeon regarding this and report any abnormality. Consult your dietician as well.