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Endoscopic Thoracic Sympathectomy: Procedure, Causes, and Recovery

Endoscopic Thoracic Sympathectomy Procedure

Endoscopic Thoracic Sympathectomy Facts

  • Treats conditions like hyperhidrosis (excessive sweating), facial blushing, or Raynaud’s disease.
  • The sympathetic nerves targeted in ETS regulate involuntary bodily functions, including sweating and blood flow.
  • ETS interrupts the signals from these nerves to reduce sweating or alleviate symptoms such as blushing or cold hands.
  • ETS surgery is considered a last resort treatment option for severe cases of hyperhidrosis or other conditions when conservative treatments have failed.

What is Endoscopic Thoracic Sympathectomy surgery?

Endoscopic thoracic sympathectomy (ETS) is a minimally invasive surgical procedure aimed at alleviating excessive sweating, medically known as hyperhidrosis, particularly in areas like the palms or face. This surgery targets the sympathetic nerves responsible for regulating sweat production. By interrupting these nerves, which transmit signals from the spine to the sweat glands, ETS aims to reduce or eliminate excessive sweating.

Function of the sympathetic nerves

The sympathetic nerves controlling sweat glands originate from the spinal cord and travel along the sympathetic chain located beside the spine. During thoracoscopic sympathectomy, this sympathetic chain is severed to halt the transmission of nerve signals to the sweat glands, effectively reducing sweating. This procedure is irreversible once performed.

Since different regions of the body are governed by specific spinal levels, precise interruption of the sympathetic chain is essential. For treating primary hyperhidrosis of the hands, the sympathetic chain is typically severed at the third to fourth rib level to effectively target the affected areas.

Thoracic Sympathectomy Causes

Some of the reasons for which this particular surgery can be opted are as follows:

  • Temporary discomfort or pain at the incision site
  • Temporary numbness or tingling in the hands or underarms
  • Rarely, infection at the incision site
  • Risk of pneumothorax (collapsed lung) during the procedure
  • Compensatory sweating in other areas of the body, such as the back or abdomen, in some cases

Thoracic Sympathectomy Procedure

During a procedure known as thoracoscopic sympathectomy, or more commonly referred to as endoscopic thoracic sympathectomy (ETS), patients are placed under general anaesthesia. Their arms are positioned at a 90-degree angle to the body to facilitate access to the area just below the underarm, where the operation is performed.

Starting on one side of the body, the anaesthesiologist deflates one lung to enable the surgeon to reach the sympathetic nerve chain. One or two small incisions are made underneath the armpit, typically between the second and third ribs.

A small camera attached to a scope is inserted through the incision to provide the surgeon with a view of the inside of the chest and the sympathetic nerve chain. Using a device called low-voltage electrocautery, the surgeon cuts and seals the nerve chain at the optimal location to alleviate the patient’s hyperhidrosis. The incision is then sutured with self-dissolving stitches. Most patients are discharged from the hospital on the same day and can usually resume work or school within a few days.

For individuals with severe hyperhidrosis who have exhausted other medical treatments, this surgery offers a permanent solution to their problem. In nearly all cases, it effectively resolves excessive sweating in the hands and underarms. The effects of the surgery are often immediate, with patients frequently expressing amazement upon waking up to find their hands warm and dry for the first time in years.

Recovery from Thoracoscopic Sympathectomy

Recovery from ETS surgery typically involves a relatively short and straightforward process. Patients may experience some discomfort or soreness at the incision sites, which are usually small and heal quickly. Most individuals can return home on the same day as the surgery and resume normal activities within a few days.

However, it’s essential to follow post-operative instructions provided by the medical team, including avoiding strenuous activities for a brief period and keeping the incision sites clean and dry. Patients may also experience temporary changes in sensation or sweating patterns as the body adjusts to the altered nerve function. Overall, with proper care and monitoring, the recovery from sympathectomy surgery is generally smooth, and patients can expect to enjoy the benefits of reduced sweating in the treated areas.

Outcomes of Thoracoscopic Sympathectomy Surgery

The outcomes of thoracoscopic sympathectomy surgery typically include significant improvements in hyperhidrosis symptoms, particularly excessive sweating in the hands and underarms. Patients often experience immediate relief from sweating following the procedure, with many reporting dryness in the treated areas for the first time in years. The surgery offers a permanent solution for most individuals, effectively addressing severe hyperhidrosis that has not responded well to other treatments.

Additionally, the procedure is minimally invasive, with relatively short recovery times and minimal scarring. Overall, sympathectomy for sweating can significantly enhance patients’ quality of life by alleviating the physical and emotional burdens associated with excessive sweating.

Precise endoscopic thoracic sympathectomy surgery by Dr Taj Chowdhry

Experience lasting relief and renewed confidence with Dr Taj Chowdhry’s precise endoscopic thoracic sympathectomy surgery. With a focus on precision and patient care, Dr Taj brings expertise and skill to every procedure, ensuring optimal outcomes and improved quality of life for his patients.

Book an appointment for a future free from excessive sweating.

Quick FAQs

  • High Success Rate: ETS has a high success rate in effectively reducing or eliminating excessive sweating (hyperhidrosis) in treated areas such as the palms, underarms, and face.
  • Immediate Results: In many cases, the effects of ETS are immediate, with patients noticing a significant reduction in sweating shortly after the procedure. This immediate relief can lead to improved quality of life and increased confidence.
  • Improved Quality of Life: By effectively controlling excessive sweating, ETS can significantly improve patients’ quality of life. Relief from the physical discomfort and social embarrassment associated with hyperhidrosis can lead to enhanced self-esteem, confidence, and overall well-being.
  • Versatile Treatment Option: ETS is a versatile treatment option that can benefit patients with various forms of hyperhidrosis, including primary focal hyperhidrosis and secondary hyperhidrosis. It offers a viable solution for individuals who have not responded to conservative treatments or who seek a more permanent solution.
  • Minimised Downtime: With its minimally invasive approach and quick recovery, ETS allows patients to resume normal activities and daily routines relatively soon after the procedure. This minimised downtime enables patients to return to work, school, and other activities without significant interruption.

ETS is considered a permanent solution for hyperhidrosis. However, some patients may experience compensatory sweating in other areas of the body after the procedure.

As with any surgical procedure, ETS carries some risks, including infection, bleeding, and nerve damage. Side effects such as compensatory sweating, gustatory sweating (sweating while eating), and changes in body temperature regulation may also occur.

During the consultation, the surgeon will review your medical history, discuss your symptoms and treatment goals, and perform a physical examination. They will also explain the procedure in detail, including potential risks and benefits.