What are the main contraindications for ETS?
Any surgeon who attempts to perform endoscopic thoracic sympathectomy should be very well versed and experienced with the anatomy and technique in doing the procedure. This experience should include being proctored by an experienced ETS surgeon. Very few contraindications can exist. Amongst them are obesity which makes the exposure of the sympathetic chain within the chest cavity somewhat difficult and hazardous. Other relative contraindications are previous thoracic surgery cases that can produce a lot of scar tissue and adhesions that would prevent easy access to the site where the sympathetic chain is located. It still can be tried but a good surgeon should know the limitations.
As always perspective patients are encouraged to discuss hyperhidrosis with an experienced surgeon.