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Thoracoscopic Sympathectomy: Before Your Surgery

What is a thoracoscopic sympathectomy?

Thoracoscopic sympathectomy is surgery to cut or clamp the sympathetic nerves. These nerves run down both sides of the spine. The surgery may be done to help control heavy sweating of the hands. It also may be used to treat chronic pain or other problems with the sympathetic nerve system. This surgery may also be called endoscopic thoracic sympathectomy.

You will get medicine to make you sleep and prevent pain during the surgery. The doctor will make two or three cuts (incisions) in the spaces between your ribs near your armpit. The doctor will put a thin, lighted tube with a camera on it into your chest through one of the incisions. This tube is called a scope. It lets your doctor see inside your chest. Then the doctor will guide small surgical tools through the other incision. The doctor will use these tools to cut or clamp the nerves. The procedure can then be done on the other side of the chest.

The incisions are usually closed with stitches that will dissolve on their own. You will have small scars that will fade with time.

You will probably be able to go home the same day as the surgery. You may be able to go back to work or your usual routine in 1 to 3 weeks.

Most people will have less sweating from their hands as soon as they wake up from surgery. But sometimes there can be more sweating from the feet after surgery. This is called compensatory sweating.

After this surgery, some people notice that they feel dizzy if they stand up too quickly. This usually gets better with time.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 1 to 2 hours.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to

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