Micro ETS™ vs. Clamps

Which option is right for me?
Micro ETS™
Clamping
       
• Is not reversible without nerve graft. • Reversibility questionable when removing clamps. Very low percentage return to pre-clamp condition. Clamp removal (from the crushed area of the nerve can tear, rip, sever, or cut it).
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Disturbance - injury of tissue around nerve not required.

• Disturbance-injury of tissue around nerve required to place clamps on nerve.
• Minimal pain. • More pain, scarring of lungs to clamps and chest wall, increased recovery time, bleeding, Horner's syndrome risk goes up, etc.
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Higher improvement rates than clamping due to precise, highly selective micro-division of nerve and all accessory branches.

 • Lower success rate because clamps may fall off nerve, foreign body reaction with nerve becoming inflammed causing worse symptoms, clamp has variable effectiveness in completely stopping nerve signals. Mis-fired clamps don't stop nerve signals.
•

No foreign body left inside

 • Foreign body reactions to clamps may cause pain, recurrent symptoms and/or new symptoms to develop.
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Precise division of nerve and all branches (Kuntz) has highest improvement rate in stopping nerve signal transmission.

 • Clamps can slip off the nerve (each breath causes lung to rub against clamps) leading pain and return of symptoms if nerve regenerates.
• Only one 1/12th Inch Incision in each armpit • 2 to 3 or more incisions per side (more pain, scarring of lung, higher chance of injury to intercostal nerves leading to chronic pain from nerve damage).  Incisions are larger than 1/12th inch due to instruments used to clamp.
•

Lungs not collapsed   causing less trauma to airway/lungs.  Patient flies home the next day because lungs are not deflated.

 • Lungs collapsed (more trauma to airway/lung)
• Dissection of nerve not required. • Dissection of nerve required to remove surrounding tissue so that clamps can be placed onto nerves thereby crushing the nerve.
•

Accessory nerve branches (Kuntz nerves) are precisely cut.

 • Accessory nerve branches (Kuntz nerves) are too delicate and tiny for clamps to be placed without tearing them apart.
       
  Questions you should be asking as you consider ETS surgery:
  Don't all surgeons use the same instruments and techniques to perform ETS surgery?
  No, techniques vary widely. Micro implies not only a single micro incision but also minimizing dissection (trauma) to tissue surrronding the sympathetic nerve and all of its branches (kuntz nerve accessory fibers).
  How important is choosing an experienced thoracic surgeon to perform ETS surgery?
 

A physician's experience is critical in achieving the highest success rates due to the fact that no two patient's anatomy is exactly the same. Variations in nerve routes and anatomy can be quite great leading to missed branches of nerve causing persistent symptoms. Experience, technique, instrumentation all matter!

  What qualifies your technique as "micro" ets?
  Only one incision (1/12th inch) in each armpit, disturbance of tissue surrounding nerve(s) not required, lungs not collapsed, patient on back (not on your side which is less traumatic to the arms (brachial plexus). Accessory branches (kuntz nerves) are precisely located without disturbance of tissue then micro divisions of all branches is done to minimize persistent nerve signal transmission.
  What if my insurance won't cover the surgery?
  We work with all patents to accomodate their circumstances.  Don't eliminate yourself as a candidate without giving us a call to discuss available financial options that can help you.