Procedure of endoscopic transthoracic sympathectomy (ETS)

This procedure is not a removal of sweat glands in the direct sense. However, it has the same goal as the removal of sweat glands. It is a minimally invasive operation under general anesthesia, which takes place directly at the sympathetic borderline.

The sympathetic nervous system is part of the vegetative nervous system and thus controls unconscious bodily functions such as sweating. Overall, it has an increasing effect on the willingness to perform and behaves in contrast to the parasympathetic nervous system. Surgical access is endoscopically via the abdominal cavity.

Here, the sympathetic boundary strand ganglia, which contain the nerve cells that supply the sweat glands, are completely severed, coagulated or clamped with a metal clip. However, this procedure carries high risks and is only used in cases of severe and therapy-resistant disease progression. The results are good for hand sweating, but not so good for axillary sweating.

However, there is a high risk of developing compensatory hyperhidrosis. This is a shift of hyperhidrosis to other areas of the skin. Compensatory hyperhidrosis is very difficult to treat and should therefore not be underestimated.

Other complications include Horner syndrome, vocal cord paralysis and pleural effusions. This is due to the fact that these areas belong to the supply area of the sympathetic nervous system and are thus also injured in the event of damage. Because of these risks, metal clips are used to clamp off the sympathetic ganglia during the procedure. This ensures that the procedure can be reversed, unlike coagulation or radical removal. This is especially important in preventing the lifelong existence of compensatory hyperhidrosis.

Costs of sweat gland removal

The indication for the removal of sweat glands is always given when excessive sweat production occurs in certain parts of the body and conventional herbal and medicinal measures do not bring any relief. The removal of sweat glands is usually performed by means of suction (gland suction). In 60-80% of cases, the complaints are then resolved.

The costs depend on the time spent in the practice or clinic and whether there are complications that require follow-up treatment. Furthermore, the costs depend on the number of sweat glands to be removed. The larger the area to be treated, the more expensive the procedure becomes.

As a rule, depending on the provider, costs between 600 and 1500 EUR must be expected. This includes the treatment and the follow-up treatment. An inpatient stay is not planned for the procedure and would be correspondingly more expensive.