How it Works

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!

What areas can be treated by ETS?

Hands (Palmar Hyperhidrosis) ETS can permanently eliminate sweating in the hands.

Success with ETS


Success rate for the hands


Success rate for the underarms


Success rate for the feet

The Toronto Sweat Clinic has performed over 1000 ETS’s with great success. Our results have been presented at national meetings




How long is the procedure?

The procedure is done under a 15-20 minute general anesthetic.

How long do I need to stay at the hospital?

Patients are discharged from the hospital 2-3 hours after the procedure and the results are immediate and permanent.

Is ETS covered by OHIP?

If you are a resident of Ontario, the procedure is completely covered by OHIP (Ontario Health Insurance Plan). A referral is required.

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.

How is the procedure performed?

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

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.

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Is ETS a good option for your Hyperhidrosis?

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