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.
This kind of operation is also used to treat f.e. facial blushing and angina pectoris.

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.
We who have been operated and found ourselves with several severe side effects are off a different opinion. See
Side effects.

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