In this method, the main trunk of the sympathetic nerve are left intact, however, the rami communicanes which connect the sympathetic ganglia to the peripheral nerves are cut.

In one study that compared the conventional ETS to the super-selective ETS, the overall rate of compensatory sweating was similar in both groups.

However, the rate of embarrassing and disabling compensatory sweating was significantly less in the super-selective ETS.

This further illustrates that the more selective the surgery is, the less chance of disabling compensatory sweating.

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