Sympathectomy refers to a medical term by which the sympathetic chain is cut or clamped in order to interfere with its activity. The sympathetic chain is part of the autonomous nervous system. One of its functions is controlling the sweat glands. In patients who have hyperhidrosis, sweat glands are pathologically overactive and hence produce sweat more than the physiological need. For a better definition a typical hyperhidrosis is characterized by excessive sweating of the hands, armpits and feet. It is not the whole hand but that part below the wrist and in the feet it is the area is that beyond the ankles. This particular presentation is not appreciated by a lot of healthcare providers as the hallmark of hyperhidrosis.

hyperhidrosis nerves

Sympathectomy was performed for the last 50 to 60 years. In the past, it was performed through major incisions in the back, chest wall, or neck. Presently, with endoscopic equipment, one can perform this operation through small incisions with no trauma to muscles or other structures.

In order to treat hyperhidrosis, the surgeon must deal with an overactive sympathetic chain, which is known to be the reason for hyperhidrosis. The main reason for this overactive sympathetic chain is a genetically determined problem. From different studies gathered around the world it is known that about 2/3 of the patients have some family history for hyperhidrosis. As a matter of fact, the term hypersympathetic activity is much more appropriate to use. In this scenario, the nerve is being divided or clipped at a certain level within the chest cavity. At this time, clamping of the nerve at the T3 and T4 level is being practiced by Dr. Reisfeld as the method of choice.

Thanks to developments in the field of endoscopic surgery (surgery that uses small instruments and cameras to allow surgeons entrance into the body with miniscule incisions) this procedure can be performed with only minor discomfort.

sympathetic chain

The operation is performed on an outpatient basis. The patient is placed under general anesthesia for about one hour – the length of the surgery. Most patients are able to walk out of the medical center within 2 hours after of the surgery. Regular physical activity and return to work are possible in one week or less.

Please note: You are not eligible for this surgery if you suffer from severe cardio-respiratory illness, pleural disease, or untreated thyroid diseases. Click Here to learn more about the actual surgery.

To learn more about what we can do for you, please contact The Center For Hyperhidrosis. To contact us now, just click here.


  1. Lane Hampton  July 15, 2018

    My hands and feet dont get sweaty. My head face chest and back just get soaked. Towels, shirts, t-shirts. Its ridiculous and ruining my social and sex life!

    • Center For Hyperhidrosis  July 15, 2018

      Hi lane. The description you gave with regard to the sweating is not the one that we treat surgically. The ETS or the surgery we do is directed towards those cases of excessive palmar and plantar hyperhidrosis. You have a more total body excessive sweating which is not treated with the surgery. You have to consult with you physician about other possibilities that might cause the total sweating that you suffer from. Thanks.

  2. Lane Hampton  July 15, 2018

    I constantly sweat everywhere abive the waist. I cant seem to cool down. And when l do its for cery short periods. I carry a hand towel every place l go. Soaking 2 or 3 daily. Sitting in front of ac usually chills me before l stop sweating. And its from my head, chest, neck, stomach, back, etc…. As l write its 3am and l e sweat nonstop since 1pm yesterday.

  3. Rose Marie  November 17, 2017

    Hi goodevening,it is my big problem eversince i was at my grade school,,sweaty hands and feet and i am very interested about this surgery,,can you please help me,,im working now in taiwan.

    • Center For Hyperhidrosis  November 17, 2017

      Usually excessive hands and feet sweating(hyperhidrosis) starts around grade school or even earlier where parents feel the sweat on their babies.
      If the level of sweating in your hands can reach a dripping level you should try first some conservative methods and if those can not help you than you should consider the ETS.
      If you can call us we will be happy to discuss your particular situation. 310-557-3037. Thanks

  4. alka  August 31, 2017

    I suffer from sweaty palms and feet both. Also in general I sweat all over more than normal people. I am excited to read about this surgery but a little skeptical about long term effect and any other side effects. Where can I get information about these?

    • Center For Hyperhidrosis  September 1, 2017

      Hi Alka. If you are located in the US you can call us at 310-557-3037 and all of your questions about hyperhidrosis will be answered. Thanks

  5. mohammed  May 2, 2015

    I am suffering from excessive palmar, feet and moderate armpit sweat. Specially my palm sweat has make my engineering work terrible and my life difficult, please help me.

    • Center For Hyperhidrosis  May 2, 2015

      If you live in the USA or any other place you can call me and all the questions you have about excessive hands and feet sweating will be answered. 310-557-3037. Thanks