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Hyperhidrosis Forum

Ranking of ETS Surgeons by Experience (see notes underneath table)

The vast majority of the surgeries listed in the above ETS surgeon rankings table occurred after 1985 when ETS was enhanced and popularized in Sweden (in fact, most of the surgeons who have operated on less than 500 patients began performing ETS only after 2000). Consequently, the vast majority of these surgeries were done endoscopically (rather than using the old open sympathectomy method). Most of the patients who had the ETS surgeries listed above are still alive and there might very well be at least half a million people alive worldwide with portions of their sympathetic nervous system destroyed. Really amazing if that is true.

In Asian countries such as China, Japan, South Korea and Taiwan, hyperhidrosis is far more prevalent than in the rest of the world so a surprising number of ETS surgeries have been performed in those countries over the past decade. In China, statistics and studies on ETS are hard to come by (especially in English), but in Taiwan and Japan, I had some reliable figures from which to base my estimates off of. As China, with its 1.3 billion population, continues to rapidly develop economically, it will probably be common to see tens of thousands of ETS surgeries taking place in the country in the near future. Surprisingly few ETS surgeries seem to have occurred in India, but this should also change as the country with over a billion people develops economically in the same manner as China. Genetically, Indians do not seem as susceptible to hyperhidrosis as Oriental Asians, and Indians (as well as Africans) do not require surgery for facial blushing due to their darker complexions. Besides Asia, ETS surgeries are also very prevalent on a per capita basis in Scandinavian countries (often for facial blushing) and Israel (typically for hyperhidrosis).

The "other US/China/Taiwan/Russia etc..." category in the above table is my estimate based on reading various studies or their abstracts and also based on conjecture (after considering the number of hospitals in a country, number of ETS surgeons in a country, GDP per capita, genetic variances, skin color prevalence (for facial blushing) in a country, and so on). In the US, there are over 5,000 hospitals and at least several thousand of these have a signficant thoracic/vascular surgery department. The majority of the heads of these departments have performed ETS surgeries, sometimes for symptoms other than hyperhidrosis or facial blushing. However, most have not performed greater than 100 ETS surgeries and are not listed individually in the above table. In contrast, private surgeons in the US who specialize in ETS surgery (along with several other unrelated surgeries in many cases) are extremely active in internet marketing of ETS -- so you will notice quite a few experienced US surgeons in the table above with their own private practices.

Note that the above statistics refer to each patient as one surgery. Some surgeons have been known to inflate (i.e., double) their experience by quoting body sides operated on (including sides for repeat operations). Finally, virtually all of the experienced surgeons in the table above have performed a number of surgeries at their clinics with other lesser known surgeons, but I give the main surgeon credit for all surgeries if I feel that he accounts for the vast majority. Interestingly, I could not find a single female ETS surgeon in the world.

Beware that an experienced surgeon does not necessarily equate to being an ethical and skilled surgeon. In fact some of the longest practicing and most respected surgeons have performed relatively few surgeries per year as a result of discouraging or rejecting many types of patients (in my opinion, axillary hyperhidrosis or Raynaud's Syndrome should not be treated with ETS). Surgeons who have no published studies under their belt, and who have no or very limited presence at international conferences, but who have still operated on thousands of patients should be avoided as a precaution. It is very easy to find out such things if you are a prospective patient, and hopefully this website will help you in your research.

I do not recommend endoscopic thoracic sympathectomy until all nonsurgical hyperhidrosis treatments are fully explored. Some patients (a minority) will not find any remedy to be effective, and will decide to go ahead with ETS surgery. In that case, the above ETS surgeon rankings table will be useful to you in making your decision. Moreover, I highly recommend you read the following page on this site before making your decision: choosing an ETS surgeon.