Endoscopic thoracic sympathectomy (ETS) is surgery to treat excessive sweating (hyperhidrosis), usually of the palms or face.

ETS surgery turns off the nerve the signals the body to sweat too much. The procedure is done while you are asleep under general anesthesia.

The surgeon makes two or three tiny cuts under the arm. Your lung will be collapsed so the surgeon has more room to work. A tiny camera, called an endoscope, is inserted to guide the surgeon to the nerve associated with the overactive sweat gland. The surgeon removes or destroys the nerve, and returns the lung to normal. The wound is closed with stitches. The identical procedure is done on the other side of the body.

The surgery takes about 30 minutes.

The procedure is usually performed on patients with excessively sweaty palms. It may also be used to treat extreme facial sweating. It is only used when other treatments have failed. It does not work as well on those with excessive armpit sweating.

Surgeons who perform ETS must receive special training. Before having this surgery, make sure your doctor is properly trained.

You may not be able to have this surgery if you have heart, lung, or thyroid disease.

Risks of the procedure include artery damage, nerve damage, and increased sweating.

New sweating occurs in about 50% of patients.

Most patients usually go home the next day. You may have pain for about a week.

Endoscopic thoracic sympathectomy for palmar hyperhidrosis. Ann Thorac Cardiovasc Surg. 2006 Apr;12(2):81-2.