- Endoscopic thoracic sympathectomy (ETS) involves division of the thoracic sympathetic chain between T2 and T4.
- The main indication for ETS is the treatment of palmar hyperhidrosis.
- The most common method of anaesthesia for ETS uses intermittent positive pressure ventilation via a standard tracheal tube.
- Perioperative risks are low, but complications can be devastating.
- Postoperative compensatory sweating occurs in almost 50% of patients.
"Sympathectomy is a technique about which we have limited knowledge, applied to disorders about which we have little understanding." Associate Professor Robert Boas, Faculty of Pain Medicine of the Australasian College of Anaesthetists and the Royal College of Anaesthetists, The Journal of Pain, Vol 1, No 4 (Winter), 2000: pp 258-260