Thoracoscopic Sympathectomy

Also known as: endoscopic thoracoscopic sympathectomy, ETS, minimally invasive thoracic sympathectomy.

What is thoracoscopic sympathectomy?

Sweat glands are stimulated to produce sweat by nerves that come from the spinal cord and run along each side of the spine in a chain called the sympathetic nerves (sympathetic nervous system). Children with excessive sweating (hyperhidrosis) may sweat from different parts of the body, like the hands, feet, under the arms, or the face and be so severe that sweat drips onto other people (when shaking hands for example) or onto writing material. It may be triggered by exercise, stress and embarrassment or have no known triggering factor - may be socially embarrassing and even disabling. While there are a number of non-surgical treatments available, children may be offered a minimally invasive surgical procedure called thoracoscopic sympathectomy. It involves cutting the sympathetic nerves that control sweating.

What happens during the procedure?

The procedure is typically done with the patient under general anesthesia, and with a tool called an endoscope that has a light and a camera to guide the surgeon. Tiny incisions are made in the skin to access the sympathetic nerves, and the lung may be deflated to give the surgeon more room to work. Then the sympathetic nerves are located and cut. The lung is reinflated, and the wounds are closed. Many children may be discharged the same day and patient satisfaction is usually outstanding.

Is any special preparation needed?

Your child will need to avoid food, drink or certain medications before the procedure.

What are the risk factors?

Risk of anesthesia, infection, bleeding, discomfort, breathing problems, air or blood collection in the chest, increased sweating, a slow heartbeat or damage to surrounding organs and tissues are potential risks.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: March 26, 2019 12:30 PM