|Sympathectomies have been performed for many
years. From the beginning it was a very large operation.
The surgeon went through open surgery
from the back side towards the sympathetic chain where
parts of the sympathetic ganglia was removed. We believe that
the operation is known since the beginning of 1900.
In 1920 a surgeon by the name of Kotzareff made the first (?) sympathectomy against hyperhidrosis. In the 1930's the american neurosurgeon Smithwick used sympathectomies as a way to treat high bloodpressure.
The results of the operation was not always as good as one had hoped for. The surgery sometimes lead to rather severe pain and, especially after Smithwicks operation, impotence.
In Sweden has, in "modern" time, this kind of thorakal sympathectomy been used as at treatment for palmar hyperhidrosis at least since the 1960's. The extensive surgery caused long-lasting pain, which lead to inability to work for up to about two months. These disadvantages probably lead to the developing of Endoscopic Thoracic Sympathectomy (ETS).
In 1978 a surgeon by the name of Kux described a surgery with a
"thoracic endoscope for sympathectomy". Endoscopic Thoracic Surgery (ETS) has
been performed in Sweden since about 1985. Instead of cutting the
sympathetic nerve during open surgery, the operation is performed through
one or two endoscopes which is inserted between the ribs into the chest.
From the patients view this operation is much more "mild". Usually he/she
can go back to work after at the most 7-10 days.
The operating hospitals claim in their marketing that ETS
does not cause any serious side effects. The only side effect that is
confirmed is that Horner's Syndrom can occur in a few cases, and that
compensatory sweating can occur in 10 - 70% of the patients. (These figures
varies between different operating hospitals). They also claim that the "CS" is very
mild and tolerable.