Endoscopic transthoracic sympathectomy

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Under the endoscopic transthoracic sympathectomy (ETS) is defined as the operational division of individual ganglia of the sympathetic nervous system for the treatment of excessive sweating ( hyperhidrosis ) or specific peripheral circulatory disorders.

indication

Today, ETS is a promising treatment method for hyperhidrosis of the armpits, hands or face. However, there are also critical voices, especially considering the possible complications, that recommend this operative solution only as a last resort. The tap water iontophoresis is just as successful; but requires lifelong regular treatments.

technology

General anesthesia is required for the operation .

The procedure is minimally invasive with special endoscopic instruments through one or more small incisions in the armpit and usually takes no longer than 30 minutes on either side of the body. In the chest cavity, one or more of the nerve ganglia along the vertebral bodies that stimulate the sweat glands are severed or interrupted using various techniques. The interruption with brackets is usually recommended because the operation remains reversible, i.e. reversible again. This makes sense if the compensatory sweating that always occurs is even more disadvantageous than the actual sweating before.

After an ETS, the patient can usually leave the hospital after a few days.

In Germany, the ETS is paid by the statutory health insurances (it is necessary for the patient to contact the health insurer before a planned operation in order to clarify the assumption of costs). A referral from a specialist (usually a dermatologist) for an outpatient presentation is sufficient.

Complications

Possible consequences

So-called compensatory sweating often occurs . Compensatory sweating means the secretion of body sweat in other body regions. After an ETS, compensatory sweating often occurs over a large area on the back, stomach, buttocks, thighs or feet. Harlequin syndrome can rarely occur.

literature