No Sweat Surgery: Micro ETS


SAN ANTONIO, Texas. (Ivanhoe Newswire) — It’s just one nerve, but it can make or break your health and at the very least, impact your comfort level in social situations. That one nerve runs across the back rib cage and controls the sweating mechanism of the body. Now an innovative surgical technique is cutting down on hyperhidrosis, or excessive sweating.

“Even as little as kindergarten or first grade, having constantly sweaty hands,” said Benjamin Hetrick.

Hands and feet that constantly sweat is a fact of life for people like Hetrick who have hyperhidrosis.

“I would dread doing a handshake, just handling things, the sweat was so excessive,” Hetrick told Ivanhoe.

The only solution is surgery that cuts the sympathetic nerve, which regulates sweating. In the past, a sympathectomy was complicated.  Doctors would have to collapse the lungs to perform the delicate operation. But a new method called Micro ETS has changed that.

“It’s the way I use lightly pressured carbon dioxide,” said David Nielson, M.D., a thoracic surgeon in San Antonio, Texas. (Read Full Interview)

Dr. Nielsen developed the technique. Using a 1/12th of an inch incision under each arm, a microscopic scope goes to the site of the sympathetic nerve, located on the ribs between the shoulder blades. Carbon dioxide is then pumped into the area between the lungs and the ribs, creating a space.

“It lifts gently, or pushes the lung away from this precise area, and then I take advantage of that temporary cavity to work in,” detailed Dr. Nielsen.

No collapsing of the lungs is necessary, and the technique allows a clear picture of where the nerve is located, minimizing trauma or disturbing tissue nearby.

“I don’t have to dig the tissue out at all to find the nerve,” said Nielson.

Pain is reduced, and recovery time is quicker than the traditional nerve surgery.

“It made me a more normal person,” said Hetrick.

The sypathectomy is also very effective for treating excessive blushing and other parts of the body that have heavy sweating.

Contributors to this news report include: Cyndy McGrath, Supervising Producer; Shari St. Clair, Field Producer; Milvionne Chery, Assistant Producer; Roque Correa, Editor; Bruce Maniscalco, Videographer.



TOPIC:       No Sweat Surgery: Micro ETS

REPORT:   MB #4175


BACKGROUND: Excessive sweating may be uncomfortable at the least, but sometimes heavy sweating is a sign of a medical condition. The most common cause of excessive sweating is called primary focal hyperhidrosis affecting symmetric parts of the body such as the underarms, groin, head, face, hands, or feet. This form of hyperhidrosis affects about 1 percent to 3 percent of the population and it’s not a sign of disease or drug interaction; it usually starts during childhood or adolescent years.  This type of hyperhidrosis seems to develop from a minor malfunction in the nervous system and there’s some evidence that it could run in families. It is also common in people who are overweight or out of shape. Even though this focus type isn’t medically risky, it can cause embarrassment.  The less common type of excessive sweating is called secondary general hyperhidrosis and it causes sweating all over the body. This one can be a warning sign of thyroid problems, diabetes or infection.

TREATMENTS: While there is no cure for primary focal hyperhidrosis, there are ways to help control the symptoms like: antiperspirants, iontophoresis, medications, Botox and surgery. Secondary hyperhidrosis can often be treated too, although the approach depends on the condition causing it. One form of surgery that is performed to treat hyperhidrosis is called ETS (endoscopic thoracic sympathectomy); but it is not usually recommended due to its difficult and often irreversible side effects. During ETS surgery, surgeons attempt to interrupt the transmission of nerve signals from the spinal column to the sweat glands, preventing them from “turning on”. The procedure is performed with the patient under general anesthesia, in order for the lungs to be temporarily collapsed so the surgeons can cut or destroy the nerve paths associated with the overactive sweat glands. Even though this procedure is called “minimally invasive”, it carries with it significant risk and limited success.

NEW TECHNOLOGY: Dr. David Nielsen from San Antonio, TX has developed a new technique that is less invasive. This technique is called MicroETS and it consist of making a 1/12th of an inch incision under each arm, followed by a microscopic scope that goes to the site of the sympathetic nerve which is located on the ribs between the shoulder blades. Carbon dioxide is then pumped into the area between the lungs and the ribs, creating a space for the nerve to be found and divided without touching any tissue. This technique allows skipping the step of collapsing the lungs because it allows a clear picture of where the nerve is located. MicroETS minimizes trauma and doesn’t disturb tissue nearby, which results in less risk, pain and recovery time.
(Source: Dr. David Nielsen)


Holly Wayment

Public Relations


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Doctor Q and A

Read the entire Doctor Q&A for David Nielson, M.D., FACS

Read the entire Q&A