Endoscopic Sympathetic Surgery

  • Georg BischofEmail author
  • Peter Panhofer
  • Christoph Neumayer


Endoscopic thoracic sympathectomy (ETS) is an effective treatment option for patients suffering from primary hyperhidrosis, facial blushing, and various vascular disorders.

A thorough medical checkup aims to rule out other causes of the disturbance. Conservative treatments for hyperhidrosis patients range from topical aluminum chloride solutions, herbal therapies, and anticholinergic drugs to botox injections. Quantitative assessment of the amount and degree of sweating is dependent on the environment as well as the physical and emotional situation and therefore difficult to accomplish. Most authors apply disease-specific questionnaires and quality of life instruments.

Various surgical techniques are described in this chapter, ranging from resection over cutting to clip application to achieve anhidrosis. The clipping method offers the potential of reversal surgery primarily for patients who suffer from unbearable compensatory sweating. This side effect of ETS surgery is frequently observed, but diminishes quality of life in only 5% of patients. Intra- and postoperative complications are rare, but can be life threatening. Adequate training of surgeons, informed consent of patients, and postoperative follow-up are mandatory.


Sweat Gland Sympathetic Chain Sympathetic Trunk Palmar Hyperhidrosis Horner Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors want to thank c.m. Catherine Novak for her support in editing the manuscript and providing tables and reference list.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Georg Bischof
    • 1
    Email author
  • Peter Panhofer
    • 2
  • Christoph Neumayer
    • 2
  1. 1.Department of SurgerySt. Josef HospitalViennaAustria
  2. 2.Department of SurgeryMedical University of Vienna (MUW)ViennaAustria

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