ETS (Micro-Invasive Endoscopic Thoracic Sympathectomy)

Contact Information

(608) 263-7502

(608) 265-0499


Related Conditions

Sweating Excessively (Hyperhidrosis)

Surgeons at the University of Wisconsin Hospital and Clinics now perform a new, minimally invasive procedure to safely and effectively treat hyperhidrosis, or excessive sweating. The procedure is known as ETS, or micro-invasive endoscopic thoracic sympathectomy. It involves removing the portions of the sympathetic nerve chain that cause the excessive sweating.
National studies have reported the success rates for ETS sympathectomy at 100 percent for hyperhidrosis of the hands. It is 98 percent for hyperhidrosis of the underarms, and 82 percent for hyperhidrosis of the feet. (Doolabh et al. Thoracoscopic Sympathectomy for Hyperhidrosis: Indications and Results. Ann Thorac Surg. 2004;77:410-414.)
At UW Hospital and Clinics, our thoracic surgeons have specialized training and outstanding results performing ETS sympathectomy. We have provided numerous patients throughout the Midwest permanent relief from this embarrassing disorder:
The ETS Sympathectomy Procedure
The ETS sympathectomy procedure takes about 40 minutes. You will be asleep during surgery. First, an anesthesiologist inserts a tube into your trachea (the airway from your mouth to your lungs). This helps you breathe during the operation.
The surgeon then makes two small (5mm) incisions on one side of the chest. The incisions are made just below the underarm and are hidden in the inframammary crease.
Next, the anesthesiologist deflates the lung. This allows access to the sympathetic nerve chain, which is located inside the chest, near the spine.
The surgeon then inserts a small video camera through one of the tiny incisions. Using the video as a guide, the surgeon inserts tiny instruments into the other incision. These instruments are used to remove the branches of the sympathetic chain responsible for the sweating:
  • The second and third ganglion
  • The intervening sympathetic chain
  • And the ventral and dorsal rami

Once the nerve chain is removed, the surgeon removes the instruments and camera, and the anesthesiologist reinflates the lung. The procedure is then repeated on the other side of the chest.


The surgeon leaves a tiny (4mm) chest tube on either side of the chest for a few hours after surgery. This helps the lung reopen. The remaining incisions are covered with a small bandage.