Hyperhidrosis is often a distressing, socially debilitating condition, affecting a small but significant proportion of the world population. While symptoms usually begin during adolescence, it can also occur in other age groups.

Treatment options given to patients who suffer from hyperhidrosis usually depend on the severity of their case and which body area is affected. Non-surgical treatments such as oral medications, anti-perspirants, ointments, botox injections and iontophoresis, are the usual initial options given to patients. When none of those treatments prove beneficial or effective, there are also surgical treatments available to patients seeking more permanent results.

In the past, surgical procedures done for hyperhidrosis cases usually involve a painful incision either at the chest, back or neck (e.g. upper thoracic sympathectomy). Most often than not, these highly invasive procedures result to complications such as brachial plexus, phrenic nerve injury, or Horner’s Syndrome, a condition that can cause dropping of the upper eyelids and eye dryness. In rare cases, excessive bleeding may likewise happen. Due to recent technological advances, minimally invasive surgical methods, such as thoracoscopic sympathectomy or otherwise known as endoscopic thoracic sympathectomy (ETS), were made possible.

ETS is a surgical procedure that intends to interrupt sympathetic nerve impulses sent to the sweat glands and prevent localized excessive sweating (usually in the hands and face). While the patient is under general anesthesia, a 5-mm. endoscope is inserted into a small incision made below the underarm to identify the second through fourth ganglia. The identified branches to the main sympathetic chain at each level are divided before the main chain is removed. The same procedure is done on the patient’s other side, which is crucial in preventing symptoms from recurring years later.

ETS is most effective in treating excessive hand and facial sweating, with a success rate of more than 98%. It also gives additional relief to excessive feet sweating. While it is a highly effective procedure with permanent results, it has very minimal complication rate. Incident of Horner’s Syndrome for instance, is about less than 1%.

As with most surgical procedures, ETS also has some side effects and the most common of which is compensatory sweating. Compensatory sweating occurs in about 50% of ETS patients. Also, there are reported cases of small pneumothorax after the operation, but in this case, no medical intervention is required and patients can usually go home after 24 hours.

While ETS is generally safe and a highly effective method in treating hyperhidrosis cases, it is still best for patients to look only for experienced, highly competent and certified surgeons for excellent and long-term results.