Endoscopic Thoracic Sympathectomy (ETS) is an outpatient procedure that can block the vicious cycle of nerve impulses that stimulate the sweat glands in your hands and underarm. When you think about sweating, a sequence of events leads to the sympathetic nerve firing without your control. By ablating a segment of that nerve, this cycle is blocked!

Success rates for the hands is 98% and for the underarms 94%. Sweating in the feet improves in 50% of patients.

Two, 5mm incisions are made in the underarm area allowing doctors to clearly visualize the offending nerve. The nerve is either clipped or cauterized.

Patients are discharged from the hospital 2-3 hours after the procedure and the results are immediate and permanent.  If you are a resident of Ontario, the procedure is completely covered by OHIP (Ontario Health Insurance Plan). A referral is required.

The Toronto Sweat Clinic has performed over 1000 ETS’s with great success.


Etobicoke Guardian Article on Hyperhidrosis


The procedure is done under a 15-20 minute general anesthetic. Two incisions are made on both sides of the chest:





Within your chest, a structure called the sympathetic nerve chain runs up and down along your ribs. It is the part of the nervous system responsible for the fight or flight response. By cutting or clipping the sympathetic nerve, stimulation to the sweat glands can be blocked:


Where the nerve is cut or clipped along the sympathetic chain depends on your symptoms: R=Rib, T: Interspace



As surgery is covered by OHIP, please have a physician fax a referral to our office. Once we receive the referral we will schedule your appointment