© 2005-2023 NO-ETS.COM. ALL RIGHTS RESERVED.
Although the domain name of this website suggests a complete rejection of Endoscopic Thoracic Sympathectomy (ETS) surgery to treat hyperhidrosis, that is not true. Sympathectomy does seem to be a highly effective remedy for many people suffering from sweaty palms. In fact, I am reasonably satisfied with the results of my own ETS surgery in 1998 to treat my excessively sweaty hands. However, there are nowadays a number of safer alternative non-surgical remedies that can often cure or ameliorate hyperhidrosis. ETS surgery destroys part of your sympathetic nervous system (SNS) permanently and causes side effects in all patients. Because so many people are getting ETS and tolerating the usually minimal side effects (at least in comparison to the original symptoms), it seems like there is no incentive for scientists and surgeons to find a cure that does not involve altering your nervous system. Moreover, even with the latest surgical techniques, a small minority of patients still end up getting unbearable side effects.
The most common side effect of compensatory sweating (CS), if present, is immediately evident after surgery, especially in summer. However, some side effects such as gustatory sweating (forehead perspiration when eating or sometimes even when smelling spicy foods) and cold hands often appear several years after the surgery. After my own ETS surgery in 1998 that successfully cured my very bothersome excessive hand sweating, I got CS in my feet, which at the time was though to be quite unusual since most people get CS on their trunk, chest or back areas. My annoying side effect was later relieved by Hidrex iontophoresis as well as by Idromed iontophoresis.
Nonsurgical solutions do not always work, and even when they do, they require persistence and your having to maintain a treatment schedule. Hopefully, we will some day soon have a solution to localized hyperhidrosis that is better than the current options and that does not involve autonomic nervous system related surgery. In fact, for armpit sweating problems, there have been several treatment breakthroughs in recent years that I discuss further below. The future looks very promising for people suffering from localized hyperhidrosis, and it might be worth delaying surgery.
In 1998, the internet was still in its relative infancy and hyperhidrosis related information was dominated by pro-sympathectomy websites. Today, if I was doing it all over again, I would definitely try iontophoresis machines first before contemplating surgery to relieve excessive hand sweating. Sympathectomy should only be considered as a choice of treatment after the numerous other alternatives have been explored (discuss in the hyperhidrosis forum). Most surgeons downplay and don't fully disclose all the side effects of sympathectomy, sometimes due to the lucrative nature of this half-hour surgical procedure that does not even require overnight hospital stay. Moreover, a majority of surgeons devote minimal information (that is often unusually critical) on their websites regarding potentially successful alternative treatments such as iontophoresis, Botox and Robinul or Robinul Forte.
This website's mission is:
Besides hyperhidrosis, endoscopic thoracic sympathectomy is also sometimes used to "cure" severe Facial Blushing, Social Phobia, Reflex Sympathetic Dystrophy, Causalgia and Raynaud's Syndrome, and in rare instances, even PTSD, Schizophrenia and a number of other such mental disorders. Many surgeons have stopped offering ETS as a cure for most of these problems due to frequent ineffectiveness, symptom re-occurrences and unwanted side effects.
Almost all well known surgeons no longer offer sympathectomy for the sole purpose of eliminating excessive armpit sweating. I think it is a very bad decision to have ETS surgery if you only have localized hyperhidrosis in the armpit area. For a lot of people, excessive armpit sweating is not bothersome once they apply deodorants or antiperspirants. For others, Botox is often highly effective at stopping armpit sweating for at least six months at a stretch. Even various types of sweat gland excision surgeries in the armpits are potential solutions that are far less invasive than ETS.
New laser sweat ablation type procedures seem to be quite effective at significantly reducing armpit sweating. Moreover, in 2011, a noninvasive outpatient microwave radiation based armpit sweating treatment called miraDry received FDA approval and has since gotten many good reviews from both physicians and patients alike. Other electromagnetic radiation and ultrasound wave based excessive sweating treatments have also become popular in recent years.
Many surgeons nowadays also recommend not getting ETS just to eliminate excessive facial sweating or facial blushing, since people with such problems see significantly higher side effects after having ETS in comparison to people who have palmar hyperhidrosis or people who have multiple areas with excessive sweating.
Lumbar sympathectomy to stop excessive feet sweating was on the verge of obsolescence until 2008, when some eminent surgeons felt that its side effects were not as significant as thought of previously, especially with regards to the most feared side effect of retrograde ejaculation. Just as was the case with ETS surgery, where surgical advances in the mid-2000s led to surgeons not cutting or clamping T-2 for hand sweating anymore (they usually go for T-3 or, in some cases, T-4), surgical advances for lumbar sympathectomy resulted in surgeons not cutting or clamping L-2 (they go for L-3 or L-4). These surgical advances were largely due to the work of surgeons in Brazil and parts of Western Europe. I still recommend not getting lumbar sympathectomy for now until more longer-term results come in. In the US, only one surgeon seems to be performing this surgery as of 2013.
Check out the pages on hyperhidrosis treatments and short-term and long-term side effects from having hyperhidrosis surgery before proceeding to the forums or booking the surgery. Note that the ganglions/nerves that are killed during ETS surgery are underneath the chest near the ribs, and are not just your sweat glands inside your hands or feet or face being destroyed as you would think. These ganglions are part of your sympathetic nervous system that affects numerous parts and mechanisms of your body -- ranging from your hypothalamus to heart rate. Moreover, the effectiveness of ETS nerve graft reversal surgery is still unclear.