What are the side effects for Endoscopic Thoracic Sympathectomy?
ETS (Endoscopic Thoracic Sympathectomy) related Side Effects:As with any surgical procedure there are certain risks. Dr. Reisfeld is one of the most experienced and recognized hyperhidrosis surgeons in the world and he takes the time to explain both the benefits and the risks associated with the procedures to all his patients. We encourage you to discuss all your concerns with Dr. Reisfeld and he will be happy to answer your questions. He has received every question imaginable so do not be afraid to ask! (See our frequently asked hyperhidrosis questions section)
Most common side effects for the ETS Procedure (Sweaty Palms):
Since compensatory sweating is the most common side effect more should be known about it and what is being done to improve upon it. Over the last several years, the clamping method procedure has created an improvement with regard to the reversal possibility. Recently, lowering the level of the clamps to the third and fourth ganglia has had some positive effects with lowering the amount of compensatory sweating. This portion of the site will be updated as more is known. Dr.Reisfeld is very involved in making sure these types of issues are relayed to the public in order to benefit everyone.
A much smaller group of 3% - 5% will experience more severe compensatory sweating. Severe compensatory sweating, will make those patients less satisfied. Severe compensatory sweating can be defined as very troublesome especially when it soaks through the clothing. It is a difficult situation especially in hot humid summer days. So far attempts to find a common thread among those patients who develop severe compensatory sweating has not yet yielded any concrete answers. However, most patients who develop mild to moderator compensatory sweating say that they are not troubled by this extra perspiration and it is preferable to sweaty palms. On the other hand those patients who develop severe compensatory sweating will complain about this excessive extra sweating especially in hot humid weather or certain anxious situations. It is important to note compensatory sweating would be a side effect for anyone receiving ETS whether they had hyperhidrosis or not prior to the surgery.
Less common side effects for the ETS Procedure (Sweaty Palms):
Temporary Recurrence after the surgery:
This question of why recurrence is sometimes asked from previously operated patients or potential patients. Again I would like to reiterate that this is rare and not a result of one method vs. another. Unfortunately the exact physiological – anatomical explanation is not yet completely known. Hopefully with time more studies will shed light on the problem.
Surgeons doing the procedure for the wrong reasons:
Gustatory sweating is another side effect which occurs in about 5% of cases. This condition, in which patients notice that they tend to experience increased sweating while eating or smelling certain foods, develops in rare instances. Please discuss side effects thoroughly with your surgeon.
What are the risks and/or possible complications of the operation?
Noppen M, Dendale P, Hagers Y, Herregodts P, Vincken W, D'Haens J. Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis. J Auton Nerv Syst 1996;60:115-20.
Generally, T2 sympathectomy has a beta-blocker-like activity that is thought to affect the heart in a positive manner. Thus, some patients may experience a modest decrease in heart rate at rest and during maximal exercise. We observed a small decrease in resting heart rate in approximately 3% of patients after the ETS procedure. Importantly, there are no reports of any long-term adverse effects of ETS on cardiovascular function. For high-end athletes, there will be an inability to raise the heart rate above 138 beats per minute. However, since the conversion from the T2 to the clamping of the T3-T4 levels, the number of patients complaining about heart rate reduction has decreased, and this is one of the reasons Dr. Reisfeld has decided to move the clamping level to T3-T4 when performing the surgery for Hyperhidrosis. In fact, there are patients whose heart rates went up to 150 – 160 per minute. Serious athletes to whom this lifestyle is important should weigh very heavily the pros and cons of the surgery with regards to their vocation. As more is learned about this, we will share the information on this site.
Do you have any questions that were not answered here? Would you like to speak with Dr. Reisfeld to answer those questions? To learn more about what we can do for you, contact The Center for Hyperhidrosis by contacting our office.
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