Endoscopic Transthoracic Sympathectomy

What is Endoscopic Transthoracic Sympathectomy?

Endoscopic transthoracic sympathectomy (ETS) is a surgical procedure which is carried out under general anaesthetic. During the procedure, the surgeon will make incisions in the armpit, deflate the lung very slightly and cut away some of the nerve tissue in the chest, where the sympathetic nerve system forms a chain. The lung is deflated to expose the nerve system and an endoscope is then inserted through the incisions to guide the doctor.

Once the nerve has been cut or 'damaged' then the sweat glands, which are stimulated by that nerve, will not conduct a signal and therefore no sweat will be produced.

ETS may be effective but it does carry risks, as with all surgical procedures. These include:

• Compensatory sweating
• Damage to the lung
• Horner's syndrome: this is a syndrome characterised by a drooping eye and a lack of movement and sensation on one side of the face. Horner's syndrome is caused by damage to the nervous system and it may be impossible to reverse this damage.