As any surgical procedure, ETS is associated with some degree of risk, but is overall a very safe procedure with few severe side effects. The risk-benefit assessment of the procedure needs to be done in the context of the original condition.  The results presented below refer to the largest published study of more than 1,000 patients who had E.T.S. performed by various experienced surgeons (see Literature Reference List).

ETS-C is a new procedure that has already been tested in more than 1,000 patients with excellent results.  Instead of burning the nerve by electro-cautery, which causes irreversible results, a clamp is placed on the sympathetic nerve to block nerve transmission.  The clamp may be removed if the patient develops unacceptable compensatory sweating, and if done early enough, i.e. during the first weeks - months, the effects of surgery may be reversed.

POSITIVE EFFECTS OF ETS / ETS-C

Excessive Hand Sweat will be cured in almost all patients
Your hands will be warm and dry immediately following the procedure. The overall success rate for the removal of hand sweat is close to 100%.

Excessive Facial Blushing will be cured in most patients
Severity of facial blushing attacks should be reduced by about 80% in most patients. Some patients experience a 100% elimination of their facial blushing problem.

Excessive Facial Sweating may be eliminated in most patients
The success rate for the removal of facial sweat is about 95%.

Excessive Axillary (Underarm) sweating will be reduced or eliminated
By extending the ETS procedure to include the T3 nerve, axillary (underarm) sweating can be eliminated.

Excessive feet sweat may be eliminated
Some patients note less sweating of the feet after ETS.

A slight reduction in heart beat may occur
Patients have reported that they are calmer under stressful situations, and no longer notice any rapid heart rate or palpitations due to an irregular heart rate. The heart rate is slightly reduced and is considered a positive side effect.

Migraine Headaches
Patients with migraine headaches note reduction in the number of these headaches.

Stage Fright Tachycardia
Palpitations caused by anxiety when making presentations in public, may also be substantially reduced.

NEGATIVE EFFECTS OF ETS / ETS-C

Compensatory sweating (CS)
After ETS, about 85% of patients will note that they seem to sweat more on the trunk and legs of the body than previously. For 75% of these people it is mild, about 5% find it moderate, and 2% have found it severe. Most feel that it is not a major problem, that it occurs during periods of excessive stress or exercise. Some find it excessive and annoying, but acceptable. A few others are significantly hampered by their CS but don’t want reversal.

Gustatory Sweating (GS)
Increased sweating after eating certain foods has also been described, but is much more unusual, occurring in perhaps 3-5% of patients.

Horner’s Syndrome
This occurs if the T1 (stellate) ganglion is damaged at the time of surgery. It results them ptosis (drooping of the eyelid), myosis (constriction of the pupil) and exopthalmus (forward protrusion of the eye). Fortunately, this is a very uncommon complication by the thoracic approach, because the T1 ganglion is at or above the level of the first rib, outside the thoracic cavity, and is not easily damaged by this approach.

Pneumothorax (persistent air leak from lung)
This would be a very unusual complication. <3%, in the hands of an experienced surgeon, and would be the result of damage to the lung surface. A few patients may experience delayed expansion of the lung post op for about 12 hours, delaying their discharge from hospital slightly. Pneumothorax could also occur in someone who has bullous disease of the lung, or cysts on the surface of the lung. These patients often present with spontaneous rupture of one of these cysts, causing collapse of the lung. Fortunately, this can be recognized at the time of ETS surgery and the cyst removed. This could be an added benefit of the procedure, preventing problems later in life.

Bleeding
Bleeding can occur from the port sites and also from the veins adjacent to the sympathetic chain. Special ports have been devised to prevent this problem, and surgical skill is required in dealing with the sympathetic chain to prevent any bleeding from the surrounding vessels.

Intercostal neuralgia
This nerve pain can result from mild nerve damage during the operation, or as a result of insertion of one of the ports. It may affect the arm, torso, or skin in those areas. It is not a common occurrence, and usually subsides in 3-6 weeks.

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