ETS Technique
This advanced and innovative technique has proven to be an effective treatment for many patients. ETS-C involves the placement of tiny,
titanium clamps over the sympathetic nerve. This allows
the procedure to be potentially reversed as opposed to traditional
ETS surgery in which the nerves are severed.
The reversibility of our procedure has been demonstrated
to range between 1-6 months following surgery, but there
is no guarantee of complete reversal. On the other hand,
there is
no potential for reversal with the ETS cutting technique
performed by many other surgeons.
ETS-C is performed under a mild, general
anesthesia and requires a skilled surgeon. Our surgeons
enter the chest cavity through two small incisions located on each side of the body just
under the armpit. A small amount of carbon dioxide (a
harmless gas) is introduced into the chest cavity in
order to gently push the lung aside. This provides a
very clear view of the sympathetic nerve chain which
is located along the spine inside of the chest cavity.
Our surgeons then expose the sympathetic ganglion
chain and place the small clamps over the nerve
responsible for the sweating and/or blushing. For hand
sweating and underarm sweating, the clamps are placed
over the 3rd and 4th ganglia (T3-T4) of the sympathetic
nerve chain. This technique best targets hand and
underarm sweating, and may also reduce facial sweating/
blushing. For facial sweating and facial blushing
specifically, the
clamps are placed over the second ganglion (T2) of the
sympathetic nerve chain.
Our technique is very precise in that we divide
any Kuntz nerves, which are believed to be present in
most individuals, but can be missed by surgeons who are
inexperienced in locating these nerves. Thorough
examination and division of the Kuntz nerves is believed
to be important in order to prevent recurrence of the
hyperhidrosis/blushing and thus the need for a second
surgery. After completion of the operation, the carbon
dioxide gas is evacuated and the incisions are closed
with an absorbable suture which does not need removal.
The procedure is then repeated on the other side. A
chest X-ray is performed to insure that the lungs
are fully inflated. The patient may resume work within
48 hours and return to sports activities in 5-7 days
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