Endoscopic sympathectomy is a surgery on your nerves that is less invasive than a standard surgical sympathectomy procedure. It treats health issues caused by overactive sweat glands.
Special nerve fibers along the spinal cord, known as the sympathetic chain, activate these sweat glands. The surgery stops nerve signals from the spine from turning on your sweat glands.
UPMC surgeons use the safest, most minimally invasive techniques available to restore comfort, confidence, and quality of life for people with overactive sweat glands — even when other treatments have not helped.
An endoscopic sympathectomy is a spinal surgery on your nerves. It uses less invasive techniques than traditional approaches and has a quicker and more comfortable recovery. During the procedure, your doctor operates on a bundle of nerves along the side of your spinal cord called the sympathetic chain.
The surgery uses an endoscope — a tube that lets your doctor operate through one or two small cuts instead of a large opening. The endoscope has a video camera and a light that allows your doctor to see the surgical area. Your surgeon will also use small surgical instruments to perform the procedure.
Endoscopic sympathectomy can be used to treat all three regions of the sympathetic nerve trunk:
The most common form of this procedure is endoscopic thoracic sympathectomy (ETS) surgery.
An endoscopic sympathectomy can treat health issues caused by overactive sweat glands, including:
This technique also treats other health issues caused by damage to these nerves.
An endoscopic sympathectomy is for people with excessive sweating or other health issues related to the sympathetic chain.
The ideal candidate for endoscopic sympathectomy is anyone who sweats so much that they are uncomfortable to the point where it limits the activities they can enjoy. People who experience excessive sweating after trying all other treatments may also be candidates.
Alternatives to an endoscopic sympathectomy include:
As with any medical procedure, an endoscopic sympathectomy has some risks.
Possible complications include:
In addition to general surgical complications, side effects may include:
Before your procedure, you will meet with your care team and have a physical exam.
Your care team may order tests, such as:
Your doctor will explain the procedure to you and answer your questions. To prepare for the procedure, you should:
On the day of your procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables like cash and jewelry at home.
Endoscopic sympathectomy is usually an outpatient procedure, so you will be discharged on the same day. You will need to arrange for someone to drive you home after you are discharged.
An endoscopic sympathectomy usually takes one to two hours.
When you arrive at the hospital, you will meet with your care team for final preparations.
You will receive an IV and general anesthesia, which means you will be asleep during the procedure and will not feel any pain.
You will be positioned on a procedure table on your stomach. Your doctor will:
After your procedure, your surgeon will close your incisions and make sure your condition is stable.
You will be asleep during the procedure and will not feel any pain. After the procedure, you may feel sore and have bruising around your incision site.
Endoscopic sympathectomy is a safe procedure. Because the procedure is minimally invasive, it involves smaller incisions than traditional procedures and reduces your risk of complications, blood loss, and pain.
After your procedure is complete, you will be monitored in the recovery area. You may feel sore around your incision site.
Most people leave the hospital within a few hours of surgery. Your doctor will let you know when it is safe to go home.
Before you go home, your doctor will tell you:
Most people can resume normal activities within one to two weeks.
You should let your surgeon know if you have:
Most people who have an endoscopic sympathectomy experience excellent short-term results and report improved quality of life. However, there is a small risk of symptom recurrence over time.
A few people may experience bothersome side effects. If these side effects are severe, additional surgery can reverse the procedure.
The success rate of an endoscopic sympathectomy is greater than 95%. Nearly all people experience some symptom relief.
UPMC surgeons use the least invasive, most effective approach to treat all types of nerve disorders. Our team is at the forefront of some of the latest approaches to endoscopic sympathectomy — promoting safer procedures, improved outcomes, and enhanced quality of life.
By UPMC Editorial Staff. Last reviewed on 2025-05-16.
