Surgeon Name: | Country | Number of ETSs Performed | Surgeon's Verification Date or My Estimate |
Chien-Chi Lin | Taiwan | 7,000 | May 2006 -- popularized the clipping method & co-invented the Lin-Telaranta classification |
Goran Claes, Christopher Drott et al. | Sweden | 6,000 | My estimate -- popularized the current minimal access ETS method in the 1980s (a surgeon asked me to add the following: the endoscopic approach was first described by Hughes in 1942 in the "Proceedings of the Royal Society of Medicine", while in his 1954 book, E. Kux claims to have started performing thoracic sympathectomies from 1940 onwards) |
Lin TS, Wang NP, Kuo SJ, Huang LC, Chou MC et al. | Taiwan | 5,000 | My estimate |
Joao Duarte | Brazil | 3,540 | May 2006 -- claims to not cut nor clip, but has developed a supposedly amazing new technique over the past four years |
Jim Garza | USA | 3,000 | My estimate -- "Over 6,000 procedures" per his old website in October 2006; couldn't find any studies by him; google search for "jim garza malpractice" to learn more. |
Rafael Reisfeld | USA | 2,800 | My estimate -- no longer does ETS for only facial blushing or facial sweating |
Sung WS, Kim YT et al. | South Korea | 2,500 | My estimate |
Timo Telaranta | Finland | 2,114 | June 2006 -- co-invented the Lin-Telaranta classification; did 150 ETS surgeries till 1996 (no reversals), 1,964 clamping sympathetic block surgeries (I still use the term ETS for simplicity) thereafter (46 reversals); surprisingly, he stopped performing sympathetic block this year and is focusing on ETS reversal operations since there are so many unhappy patients out there who should have never undergone ETS in the first place according to him, although he still believes in the positive outcome of ETS when the patient is carefully selected, including for Social Phobia; he is the world's most experienced surgeon at non-clamping ETS reversal -- although I am very skeptical about the efficacy of this expensive, intensive and possibly still experimental surgery |
David Nielsen | USA | 2,100 | My estimate -- "Over 4,000 procedures" per his website in October 2006; couldn't find any studies by him; differentiates himself by offering "Micro ETS", a registered trademark |
Jiun-Yi Hsia, Chih-Yi Chen, Chung-Ping Hsu, Shyh-Sheng Yang et al. | Taiwan | 2,000 | My estimate |
Ivo Tarfusser | Italy | 1,500 | My estimate |
Peter Kux | Brazil | 1,273 | May 2006 -- He is E. Kux's nephew |
Alberto Giudiceandrea | Italy | 1,100 | July 2006 -- couldn't find any studies by him; began performing ETS in 1994; only does clipping since 2001 |
Fritz Baumgartner | USA | 1,043 | June 2006 |
Ueyama, Matsumoto et al. | Japan | 1,000 | My estimate |
Andrievskikh, Fokin et al. | Russia | 1,000 | My estimate -- majority were operated on for upper limb arterial occlusion and Raynaud's |
Bischof, Neumayer, Zacherl, Herbst, Fugger, Plas et al. | Austria | 1,000 | My estimate -- combined Austrian results |
Marc Noppen | Belgium | 900 | June 2006 -- he is a pulmonologist; began performing ETS in 1991; only does cauterization |
David Edelman | USA | 750 | May 2006 -- began performing ETS in March 2000; treated first 600 patients with cutting method before moving to clamping; prefers not to treat facial blushing due to CS |
Christoph Schick | Germany | 730 | "Over 700" per his website in May 2006 |
Ernie Spratt | Canada | 649 | June 2006 -- Now retired, but still consulting; began performing ETS in 1992; followed Lin-Telaranta changes thereafter; operated on under one-third of consultations; since 2002, strongly discouraged ETS for facial blushing and did not offer ETS for isolated axillary sweating; quoted a more believable long-term satisfaction rate of 75 percent with older T-2 technique, and 89 percent with newer T-3/T-4 method (figures largely excluding surgery for facial blushing, which is discouraged); did 25 clipping reversals; University of Toronto |
Moya et al. | Spain | 600 | My estimate |
Chris Hensman et al. | Australia | 600 | My estimate |
Marlos Coelho | Brazil | 600 | My estimate |
Gossot, Pascal et al. | France | 600 | My estimate |
Moya, Ramos et al. | Mexico | 600 | My estimate |
Johnson, Mckenna et al. | USA | 550 | Cedars-Sinai -- "Over 1,000 procedures" per website in October 2006 |
Alan Cameron | UK | 500 | June 2006 -- performed ETS since 1984; guesses to have dissuaded 80 percent of his patients from getting ETS; does not perform ETS for isolated axillary sweating; does not think ETS works for Raynaud's or Causalgia; worked well for Social Phobia (1 case), but not necessarily justified; does not think clamping is reversible |
Prem Pillay | Singapore | 500 | May 2006 |
Jose Ribas Milanez de Campos et al. | Brazil | 500 | My estimate |
Fukushima, Makimura et al. | Japan | 500 | My estimate |
Cohen, Mares et al. | Israel | 500 | My estimate |
Adar R | Israel | 475 | My estimate -- performed 475 open sympathectomies from 1968-1992; couldn't find studies thereafter |
Lyall Gorenstein | USA | 400 | October 2006 -- began performing ETS in 1998; does not offer ETS for isolated axillary sweating; discourages ETS for facial blushing; Columbia University |
Leon Egozi | USA | 400 | My estimate |
Hratch Leon Karamanoukian | USA | 400 | My estimate |
Curtis Dickman | USA | 400 | My estimate |
Kwong, Krasna et al. | USA | 400 | My estimate -- University of Maryland |
Mack, Edgerton and Dewey | USA | 400 | My estimate -- "over 400 procedures" per website in October 2006 |
John Hramiec | USA | 350 | October 2006 -- gave an estimate of "300 to 400" in past four years; keeps iontophoresis machine in office and personally treats patients with axillary sweating with Botox |
Nicolas, Grosdiier et al. | France | 350 | My estimate -- performed many joint thoracic/lumbar sympathectomies on women |
Laureano Molins et al. | Spain | 303 | November 2006 -- began performing ETS in 1995 |
Peter Licht et al. | Denmark | 300 | My estimate |
Al-Dhoyan, El-Dawlatly et al. | Saudi Arabia | 300 | My estimate |
Neelan Doolabh et al. | USA | 300 | My estimate |
Loscertales, Arroyo et al. | Spain | 300 | My estimate |
Georghiou, Berman et al. | Israel | 250 | My estimate |
Douglas Zusman & Colin Joyo | USA | 250 | My estimate |
Jiri Konecny | USA | 234 | June 2006 |
Roger Bell | Australia | 200 | "Over 200 patients" per his website in December 2010 |
Adair et al. | UK | 200 | My estimate |
Yano, Kiriyamka, Fukai et al. | Japan | 200 | My estimate |
Schmidt, Bechara et al. | Germany | 200 | My estimate |
Saetre, Florenes et al. | Norway | 150 | My estimate -- Aker University Hospital |
Arun Prasad | India | 126 | June 2006 -- claims to be India's most experienced ETS surgeon; began performing ETS in 1993 in England |
Robert Szarnicki | USA | 100 | "Over 100 patients" per his website in December 2010 |
Anthony Yim | Hong Kong | 100 | May 2006 |
Murphy MO, Ghosh J et al. | UK | 100 | My estimate |
Kao MC et al. | Taiwan | ??? | |
E. Kux (passed away) | Austria/Brazil | ??? | Is often credited with inventing the endoscopic approach, although Hughes first described the procedure in 1942 in the "Proceedings of the Royal Society of Medicine" |
Hashmonai, Kopelman et al. | Israel | ??? | June 1992-June 1993=16 patients; June 1993-Dec 1996=116 patients; thereafter? |
Robert Zeldin | Canada | ??? | University of Toronto |
Paes, Nicolaou, Swan et al. | UK | ??? | |
Bruce McCormack | USA | ??? | |
Farshad Malekmehr | USA | ??? | |
Javier Gallego Poveda | Portugal | ??? | |
Hae-Dong Jho | USA | ??? | |
Roland Scola | Germany | ??? | |
Joaquin Garcia-Morato | Argentina | ??? | |
|
US | ??? | |
Wolf-Joachim Stelter | Germany | ??? | |
Hederman | Ireland | ??? | |
Revuelta | Spain | ??? | |
Seok-Whan Moon | South Korea | ??? | |
Han, Yun, Kyoon and Min | South Korea | ??? | |
Fischel & Cooper | USA | ??? | |
Harold Urschel | USA | ??? | |
Pavel Pafko | Czech Republic | ??? | |
Javier Alonso | USA | ??? | |
Other Japan (through June 2006) | Japan | 7,300 | One survey tallied 7,017 till year-end 2000 |
Other Israel (through June 2006) | Israel | 10,000 | |
Other Russia (through June 2006) | Russia | 10,000 | |
Other South Korea (through June 2006) | South Korea | 10,000 | |
Other Taiwan (through June 2006) | Taiwan | 16,000 | One survey tallied 9,998 patients from 1991-1996. It seems like Asian are genetically more likely to have hyperhidrosis. Since so many ETS surgeries have taken place in Taiwan, there are numerous people in the country who have significant side effects. Over the years I have seen many anti-ETS videos and blogs from Taiwan, but the links usually disappear after several years so I am not including them here. |
Other China (through June 2006) | China | ??? | Considering the high frequency of ETS in Taiwan (which has a similar genetic pool of people to China) it is quite possible that tens of thousands of people have been operated on in China, with its 1.3 billion population and state-controlled hospitals. I have seen some studies from China in journals, but not anywhere near the number as coming from Taiwan. Privatization and economic development will surely encourage tens of thousands of further ETS surgeries in China in the near future. |
Other USA (through June 2006) | USA | 20,000 |
The vast majority of the surgeries listed in the above ETS surgeon rankings table occurred after 1985 when the endoscopic approach was developed and popularized in Sweden. In fact, most of the current surgeons who have performed ETS on less than 500 patients only began performing the procedure after 2000. Consequently, the vast majority of these surgeries were done endoscopically rather than via the old open sympathectomy method. Unsurprisingly, ETS surgery side effects are less extensive than with open sympathectomy. Most of the patients who had the ETS surgeries listed above are still alive and there might very well be at least half a million people alive worldwide with portions of their sympathetic nervous system destroyed. Really amazing if that is true.
In Asian countries such as China, Japan, South Korea and Taiwan, hyperhidrosis is more prevalent than in the rest of the world so a surprising number of ETS surgeries have been performed in those countries over the past decade. In China, statistics and studies on ETS are hard to come by (especially in English), but in Taiwan and Japan, I had some reliable figures from which to base my estimates. As China, with its 1.3 billion population, continues to rapidly develop economically, it will probably be common to see tens of thousands of ETS surgeries taking place in the country on an annual basis in the near future. Surprisingly few ETS surgeries seem to have occurred in India, but this should also change as the country with over 1.2 billion people develops economically in the same manner as China. Genetically, Indians do not seem as susceptible to hyperhidrosis as Oriental Asians. Moreover, Indians (as well as Africans) do not require surgery for facial blushing due to their darker complexions. Besides Asia, ETS surgeries are also very prevalent on a per capita basis in Scandinavian countries (often for facial blushing) and Israel (typically for hyperhidrosis).
The "other US/China/Taiwan/Russia etc..." category in the above table is my estimate based on reading various studies or their abstracts and also based on conjecture after considering: the number of hospitals in a country; the number of ETS surgeons in a country; GDP per capita; genetic variances; skin color prevalence (for facial blushing) in a country; and more). In the US, there are over 5,000 hospitals and at least several thousand of these have a significant thoracic/vascular surgery department. The majority of the heads of these departments have performed ETS surgeries, sometimes for symptoms other than hyperhidrosis or facial blushing. However, most have not performed greater than 100 ETS surgeries and are not listed individually in the above table. In contrast, private surgeons in the US who specialize in ETS surgery (along with several other unrelated surgeries in many cases) are extremely active in internet marketing of ETS. So you will notice quite a few experienced US surgeons listed in the above table, with most of them having their own private practice. The ETS procedure is fairly simple. It lasts for short duration of time at under one hour after including both sides. There is at most one overnight hospital stay required for the patient, and essentially zero chance of a patient dying. And it is very lucrative for a private practitioner.
Note that the above statistics refer to each patient as one surgery. Some surgeons have been known to inflate (i.e., double) their experience by quoting body sides operated on (including sides for repeat operations) rather than patients operated on. Virtually all of the experienced surgeons in the table above have performed a number of surgeries at their clinics while training other lesser known surgeons. I give the main surgeon credit for all surgeries if I feel that he accounts for the vast majority. Interestingly, I could not find a single very experienced female ETS surgeon in the world.
Beware that an experienced surgeon does not necessarily equate to being an ethical and skilled surgeon. In fact, some of the longest practicing and most respected surgeons have performed relatively few surgeries per year as a result of discouraging or rejecting many types of patients. In my opinion, axillary hyperhidrosis or Raynaud's Syndrome should not be treated with ETS. Surgeons who have no published studies under their belt, and who also have no record of participating at international conferences should be avoided. It is very easy to find out such things via google if you are a prospective patient, and hopefully this website will help you in your research too.
I do not recommend endoscopic thoracic sympathectomy until all nonsurgical hyperhidrosis treatments are fully explored. Some patients will not find any remedy to be effective, and will decide to go ahead with ETS surgery. Other patients will get tired of daily non-surgical treatments and finally decide on surgery. In such cases, the above table will be useful to you in making your decision. Moreover, I highly recommend you read the following page on this site before making your decision: choosing an ETS surgeon.