Endoscopic Thoracic Sympathectomy (ETS): Sweaty Palm Surgery in Singapore
Sweaty palms, also known as palmar hyperhidrosis, can cause much more than temporary discomfort. For many, it becomes a long-term issue that affects work, relationships, and confidence. When conservative options like medication or iontophoresis fail, a long-term solution such as sweaty palms surgery may be considered. One of the surgical options is Endoscopic Thoracic Sympathectomy (ETS), a minimally invasive sweaty palms operation offered here in Singapore.
What Is Endoscopic Thoracic Sympathectomy for Hyperhidrosis?
Endoscopic Thoracic Sympathectomy (ETS) is a type of sweaty palm surgery that targets the overactive nerves responsible for excessive hand sweating. By interrupting the sympathetic nerve chain, ETS helps to stop the overproduction of sweat from the palms.
This procedure is one of the effective long-term treatments for palmar hyperhidrosis, especially when non-surgical options have been exhausted.
Different Types of Sympathectomy Procedures
There are primarily two types of sympathectomy procedures:
1. Endoscopic Thoracic Sympathectomy (ETS)
Focuses on treating palmar hyperhidrosis by accessing the sympathetic nerve chain within the chest cavity through minimal incisions.
2. Lumbar Sympathectomy
Aimed at treating plantar hyperhidrosis (excessive sweating of the feet), this procedure targets the sympathetic nerves in the lumbar region.
Sympathectomy Process
Endoscopic Thoracic Sympathectomy (ETS) is a minimally invasive surgery to treat severe sweaty palms (palmar hyperhidrosis).
Here’s how it works:
- Under general anaesthesia, the surgeon makes two small incisions under each armpit.
- A thin camera (endoscope) is used to see inside your chest cavity and locate the sympathetic nerve chain.
- The nerves typically involved in triggering palm sweating, usually the T2 or T3 ganglia are either cut, clamped, or sealed off.
- This blocks the signals that tell your hands to sweat excessively.
The surgery typically takes under an hour. Most patients go home the same day and often notice immediate dryness in their palms.
Is It Safe?
ETS is considered a safe and effective permanent treatment when done by an experienced specialist. However, like any surgery, there are potential side effects. The most common is compensatory sweating, where other parts of the body (like the back or thighs) may sweat more than usual after the procedure. This varies from person to person.
Is Sweaty Palms Surgery Right for You?
You might be a good candidate for ETS if:
- You’ve been struggling with severe sweaty palms that affect work, school, or social life.
- You’ve tried topical treatments, iontophoresis, or oral medication with little success.
- You’re looking for a long-term, reliable solution.
Surgery isn’t the first step for everyone, but for some, it’s the one that finally brings peace of mind. A specialist can help you decide if it’s the right fit for your situation.
Recovery and Rehabilitation
Recovery time can vary, but many patients resume normal activities within a few days post-surgery. Following the surgeon’s post-operative instructions is crucial to manage any discomfort and minimize potential side effects. Regular follow-ups will help ensure a smooth recovery process.
Indications for Sympathectomy
Sympathectomy is typically considered when conservative treatments for hyperhidrosis, such as antiperspirants, iontophoresis, or medications, have failed to provide adequate relief. The ideal candidate is someone who experiences severe sweating that significantly interferes with daily life and seeks a long-term solution.
Benefits of Sweaty Palm Surgery
- Immediate and lasting relief from sweaty palms
- Improved self-confidence in social, work, and intimate settings
- Enhanced quality of life, with less worry about handshakes, writing, or holding devices
- Minimally invasive approach with small incisions and faster recovery time
Risks and Complications of Sweaty Palm Surgery
Like any surgical procedure, sympathectomy for hyperhidrosis does carry some risks. These may include:
- Compensatory sweating, where other parts of the body (such as the back, thighs, or abdomen) begin to sweat more after the surgery. While this is the most common side effect, its severity varies from person to person.
- Infection or bleeding, although rare, as with any surgery
- Horner’s syndrome, a very uncommon complication that may cause drooping of the eyelid and a smaller pupil on one side
Our surgeon will walk you through each potential risk, answer your concerns, and explain the steps taken before, during, and after the procedure to reduce complications and support a safe recovery.
How Successful Is the Procedure?
ETS has a high success rate in significantly reducing or completely stopping sweating in the palms. Most patients report high satisfaction and long-term results. However, individual experiences can differ, so it’s important to approach this decision with realistic expectations and discuss these with your surgeon.
Alternative Treatments for Hyperhidrosis
There are primarily two types of sympathectomy procedures:
Topical Antiperspirants
Containing aluminium chloride, these can sometimes control mild cases of sweaty palms.
Medications
Anticholinergics can reduce sweating but may have side effects.
Iontophoresis
A device that passes a low voltage current through water, temporarily disabling sweat glands.
Botulinum Toxin
Injections that block nerve signals to sweat glands, offering temporary relief for six months to a year.
Sympathectomy is usually only considered when the conservative treatments above have failed to provide adequate relief.
Considerations and Precautions
Before opting for sympathectomy, it’s essential to consider all factors, including the possibility of compensatory sweating and the permanence of the procedure. Consulting with a specialist who can offer a comprehensive evaluation and detailed information about what to expect post-surgery is crucial.
Conclusion
Endoscopic thoracic sympathectomy in Singapore offers a long-term solution for individuals facing persistent, severe palmar hyperhidrosis especially when other treatments for sweaty palms have not brought relief. As a permanent sweaty palms operation, sympathectomy can greatly improve daily comfort, confidence, and quality of life. However, like all surgical procedures, it’s important to fully understand both the benefits and potential risks.
Consulting an experienced surgeon like Dr Kan, who specialises in sweaty palm surgery, can help you make an informed, personalised decision. Together, you can explore whether sympathectomy for hyperhidrosis is the right next step on your journey to dry, confident hands.
