RANKING OF ETS SURGEONS BY EXPERIENCE (see notes underneath table)

Hyperhidrosis

Hyperhidrosis Forum

Surgeon Name: Country Number of ETSs Performed
Chien-Chi Lin Taiwan 7,000 May 2006 -- popularized the clipping method & co-invented the Lin-Telaranta classification
Goran Claes, Christopher Drott et al. Sweden 6,000 My estimate -- popularized the current minimal access ETS method in the 1980s (a surgeon asked me to add the following: the endoscopic approach was first described by Hughes in 1942 in the "Proceedings of the Royal Society of Medicine", while in his 1954 book, E. Kux claims to have started performing thoracic sympathectomies from 1940 onwards)
Lin TS, Wang NP, Kuo SJ, Huang LC, Chou MC et al. Taiwan 5,000 My estimate
Joao Duarte Brazil 3,540 May 2006 -- claims to not cut nor clip, but has developed a supposedly amazing new technique over the past four years
Jim Garza USA 3,000 My estimate -- "Over 6,000 procedures" per his old website in October 2006; couldn't find any studies by him; google search for "jim garza malpractice" to learn more.
Rafael Reisfeld USA 2,800 My estimate -- no longer does ETS for only facial blushing or facial sweating
Sung WS, Kim YT et al. South Korea 2,500 My estimate
Timo Telaranta Finland 2,114 June 2006 -- co-invented the Lin-Telaranta classification; did 150 ETS surgeries till 1996 (no reversals), 1,964 clamping sympathetic block surgeries (I still use the term ETS for simplicity) thereafter (46 reversals); surprisingly, he stopped performing sympathetic block this year and is focusing on ETS reversal operations since there are so many unhappy patients out there who should have never undergone ETS in the first place according to him, although he still believes in the positive outcome of ETS when the patient is carefully selected, including for Social Phobia; he is the world's most experienced surgeon at non-clamping ETS reversal -- although I am very skeptical about the efficacy of this expensive, intensive and possibly still experimental surgery
David Nielsen USA 2,100 My estimate -- "Over 4,000 procedures" per his website in October 2006; couldn't find any studies by him; differentiates himself by offering "Micro ETS", a registered trademark
Jiun-Yi Hsia, Chih-Yi Chen, Chung-Ping Hsu, Shyh-Sheng Yang et al. Taiwan 2,000 My estimate
Ivo Tarfusser Italy 1,500 My estimate
Peter Kux Brazil 1,273 May 2006 -- He is E. Kux's nephew
Alberto Giudiceandrea Italy 1,100 July 2006 -- couldn't find any studies by him; began performing ETS in 1994; only does clipping since 2001
Fritz Baumgartner USA 1,043 June 2006
Ueyama, Matsumoto et al. Japan 1,000 My estimate
Andrievskikh, Fokin et al. Russia 1,000 My estimate -- majority were operated on for upper limb arterial occlusion and Raynaud's
Bischof, Neumayer, Zacherl, Herbst, Fugger, Plas et al. Austria 1,000 My estimate -- combined Austrian results
Marc Noppen Belgium 900 June 2006 -- he is a pulmonologist; began performing ETS in 1991; only does cauterization
David Edelman USA 750 May 2006 -- began performing ETS in March 2000; treated first 600 patients with cutting method before moving to clamping; prefers not to treat facial blushing due to CS
Christoph Schick Germany 730 "Over 700" per his website in May 2006
Ernie Spratt Canada 649 June 2006 -- Now retired, but still consulting; began performing ETS in 1992; followed Lin-Telaranta changes thereafter; operated on under one-third of consultations; since 2002, strongly discouraged ETS for facial blushing and did not offer ETS for isolated axillary sweating; quoted a more believable long-term satisfaction rate of 75 percent with older T-2 technique, and 89 percent with newer T-3/T-4 method (figures largely excluding surgery for facial blushing, which is discouraged); did 25 clipping reversals; University of Toronto
Moya et al. Spain 600 My estimate
Chris Hensman et al. Australia 600 My estimate
Marlos Coelho Brazil 600 My estimate
Gossot, Pascal et al. France 600 My estimate
Moya, Ramos et al. Mexico 600 My estimate
Johnson, Mckenna et al. USA 550 Cedars-Sinai -- "Over 1,000 procedures" per website in October 2006
Alan Cameron UK 500 June 2006 -- performed ETS since 1984; guesses to have dissuaded 80 percent of his patients from getting ETS; does not perform ETS for isolated axillary sweating; does not think ETS works for Raynaud's or Causalgia; worked well for Social Phobia (1 case), but not necessarily justified; does not think clamping is reversible
Prem Pillay Singapore 500 May 2006
Jose Ribas Milanez de Campos et al. Brazil 500 My estimate
Fukushima, Makimura et al. Japan 500 My estimate
Cohen, Mares et al. Israel 500 My estimate
Adar R Israel 475 My estimate -- performed 475 open sympathectomies from 1968-1992; couldn't find studies thereafter
Lyall Gorenstein USA 400 October 2006 -- began performing ETS in 1998; does not offer ETS for isolated axillary sweating; discourages ETS for facial blushing; Columbia University
Leon Egozi USA 400 My estimate
Hratch Leon Karamanoukian USA 400 My estimate
Curtis Dickman USA 400 My estimate
Kwong, Krasna et al. USA 400 My estimate -- University of Maryland
Mack, Edgerton and Dewey USA 400 My estimate -- "over 400 procedures" per website in October 2006
John Hramiec USA 350 October 2006 -- gave an estimate of "300 to 400" in past four years; keeps iontophoresis machine in office and personally treats patients with axillary sweating with Botox
Nicolas, Grosdiier et al. France 350 My estimate -- performed many joint thoracic/lumbar sympathectomies on women
Laureano Molins et al. Spain 303 November 2006 -- began performing ETS in 1995
Peter Licht et al. Denmark 300 My estimate
Al-Dhoyan, El-Dawlatly et al. Saudi Arabia 300 My estimate
Neelan Doolabh et al. USA 300 My estimate
Loscertales, Arroyo et al. Spain 300 My estimate
Georghiou, Berman et al. Israel 250 My estimate
Douglas Zusman & Colin Joyo USA 250 My estimate
Jiri Konecny USA 234 June 2006
Roger Bell Australia 200 "Over 200 patients" per his website in December 2010
Adair et al. UK 200 My estimate
Yano, Kiriyamka, Fukai et al. Japan 200 My estimate
Schmidt, Bechara et al. Germany 200 My estimate
Saetre, Florenes et al. Norway 150 My estimate -- Aker University Hospital
Arun Prasad India 126 June 2006 -- claims to be India's most experienced ETS surgeon; began performing ETS in 1993 in England
Robert Szarnicki USA 100 "Over 100 patients" per his website in December 2010
Anthony Yim Hong Kong 100 May 2006
Murphy MO, Ghosh J et al. UK 100 My estimate
Kao MC et al. Taiwan ???  
E. Kux (passed away) Austria/Brazil ??? Is often credited with inventing the endoscopic approach, although Hughes first described the procedure in 1942 in the "Proceedings of the Royal Society of Medicine"
Hashmonai, Kopelman et al. Israel ??? June 1992-June 1993=16 patients; June 1993-Dec 1996=116 patients; thereafter?
Robert Zeldin Canada ??? University of Toronto
Paes, Nicolaou, Swan et al. UK ???  
Bruce McCormack USA ???  
Farshad Malekmehr USA ???  
Javier Gallego Poveda Portugal ???  
Hae-Dong Jho USA ???  
Roland Scola Germany ???  
Joaquin Garcia-Morato Argentina ???  
Cliff Connery US ???  
Dr. Meyer US ???  
Wolf-Joachim Stelter Germany ???  
Hederman Ireland ???  
Revuelta Spain ???  
Seok-Whan Moon South Korea ???  
Han, Yun, Kyoon and Min South Korea ???  
Fischel & Cooper USA ???  
Harold Urschel USA ???  
Pavel Pafko Czech Republic ???  
Javier Alonso USA ???  
Other Japan (through June 2006) Japan 7,300 One survey tallied 7,017 till year-end 2000
Other Israel (through June 2006) Israel 10,000  
Other Russia (through June 2006) Russia 10,000  
Other South Korea (through June 2006) South Korea 10,000  
Other Taiwan (through June 2006) Taiwan 16,000 One survey tallied 9,998 patients from 1991-1996. It seems like Asian are genetically more likely to have hyperhidrosis. Since so many ETS surgeries have taken place in Taiwan, there are numerous people in the country who have significant side effects. Taiwan anti-ETS video and Taiwan anti-ETS blog.
Other China (through June 2006) China ??? Considering the high frequency of ETS in Taiwan (which has a similar genetic pool of people to China) it is quite possible that tens of thousands of people have been operated on in China, with its 1.3 billion population and state-controlled hospitals. I have seen some studies from China in journals, but not anywhere near the number as coming from Taiwan. Privatization and economic development will surely encourage tens of thousands of further ETS surgeries in China in the near future.
Other USA (through June 2006) USA 20,000  

The vast majority of the surgeries listed in the above ETS surgeon rankings table occurred after 1985 when the endoscopic approach was developed 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 on an annual basis in the near future if not already. Surprisingly few ETS surgeries seem to have occurred in India, but this should also change as the country with over 1.1 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 significant 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. The ETS procedure is fairly simple (short procedure duration of under one hour including both sides, no overnight hospital stay required, essentially zero chance of a patient dying) and lucrative.

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) rather than patients operated on. 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 very experienced 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. It is very easy to find out such things via google if you are a prospective patient, and hopefully this website will help you in your research too.

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. Other patients will get tired of daily non-surgical treatments and finally decide on surgery. In such cases, 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.