Endoscopic thoracic sympathectomy (ETS) is a minimally invasive surgical procedure performed to interrupt part of the sympathetic nervous system, which controls involuntary functions like sweating and blood vessel constriction. ETS is primarily used to treat conditions such as hyperhidrosis (excessive sweating), Raynaud's disease (poor circulation to the extremities), and some cases of facial blushing. The procedure involves cutting or clamping the sympathetic nerves located in the thoracic (chest) area, which are responsible for the overactive nerve signals causing the symptoms. During ETS, the surgeon makes small incisions in the chest and uses a camera (endoscope) to guide instruments to the sympathetic nerves. Depending on the condition being treated, the surgeon may either cut or clamp the nerves at specific levels, often between the second and fourth thoracic vertebrae, to reduce or eliminate excessive sweating or other symptoms. The minimally invasive nature of the surgery typically allows for faster recovery and less postoperative pain compared to traditional open surgery. Complications of ETS can include compensatory sweating, where the body produces excessive sweat in other areas, such as the back or legs, to compensate for the loss of sweating in the treated area. Other potential risks include pneumothorax (collapsed lung), nerve damage, and changes in heart rate or blood pressure due to the disruption of sympathetic nerve function. Despite these risks, ETS is often considered an effective and permanent solution for patients suffering from severe hyperhidrosis or other conditions influenced by the sympathetic nervous system.
