Are there Risks or Side-effects of Thoracoscopic Sympathectomy or ETS?
Every operation, medical procedure or medical test has some basic risks. Minimal Invasive Thoracoscopic Sypathectomy/Clipping in experienced and competent hands is a safe procedure. On occasion some surgeons have seen the following:

Compensatory Sweating is excessive sweating is other areas (such as trunk, back, scalp, thighs) after elimination of sweating from their hands and arm pits. This likely is a normal body response to body temperature changes. If the body needs to cool and you are not sweating in one part, you will need more sweat in another part. It can occur in 30-60% but is only significant in approximately 1-4% of all patients.

Gustatory sweating is an unusual condition that occurs when one kind of nerve grows into another, causing sweating with ingestion or smelling of certain foods.

Horner's Syndrome often frightens patients but is also very unusual today. The C8/T1 ganglion region powers such thing as eyelid, pupil size and to some degree facial sweating. Injury can lead to temporary or permanent changes including eyelid drop. With clipping of T3/T4 this problem has been primarily eliminated, occurring in about 0.4%.

Intercostal Neuralgia is local pain in the chest wall area of scar. Persistent or severe pain is unusual.

Pneumothorax is some degree of lung collapse after the operation. Most thoracic surgeons perform chest surgery with special breathing tubes. While they are working on one side of the chest, breathing is decreased on that side until the work is done. This does not cause any injury to the lungs and is performed routinely. Other surgeons infuse CO2 to gain exposure. In addition, it is very typical to have a small amount of residual air (sometimes reported by the radiologist as "small", "apical", "tiny" or "minimal" pneumothorax) in the chest after sympathectomy surgery. Only in the unusual situation when the air is more exaggerated ("moderate-large" pneumothorax) does one need to drain it out.

Discomfort or pain at the small chest incision and toward the back is typical after the procedure. Many patients are able to work or engage in normal activities after a day or two. Some require several days to recuperate. It is really quite individual. We often perform the procedure on Friday, allowing the patient to return home, recuperate over the weekend and then return to work Monday or Tuesday.

Less frequently seen complications (taken from International Hyperhidrosis Society) "As with any type of surgery, there are certain risks associated with this procedure. These include potential allergic reactions to the anesthetic drugs and infections at the site of the operation. Older patients are also at risk for heart problems, stroke, pneumonia, blood clots, and urinary tract infections. The incidence of any of these complications is very low (1% or less)."

"Among the ETS-specific risks is possible damage to the artery, vein, or nerve that runs beneath each rib. This risk exists because the telescope and instruments are passed between the ribs. Damage to the artery, vein, or nerve beneath a rib can cause bleeding or inflammation, leading to chronic irritation or pain. Other rare complications and side effects of ETS surgery include arterial bleeding and long-term postoperative pain and discomfort ."

Infection of the single small incision or within the chest is also an unusual complication.

Every patient is unique. Their symptoms and experiences are part of an informed and comfortable treatment decision.

Will the Surgeon or Resident Trainee Do My Surgery??
We are a committed leading center dedicated to meeting THE surgeon who will DO the actual operation. We are not engaged in casual treatment of hyperhidrosis, nor are we a large department of surgeons of various abilities or straddled with the responsibilities of a University department that must share the actual surgical task with a trainee surgical resident. Although we understand that it is necessary for every doctor to gain early training experiences. It has also been recognized, in many research reports including those in chest surgery, that increasing experience leads to exceptional results. Our center believes that the BEST of operations comes from the most experienced hands.

Information for Ontario OHIP residents