Talk:Endoscopic thoracic sympathectomy

to Do

History of sympathectomy 1890-2004

Variations on ETS techniques cutting, clamping, burning, sympathectomy, ganglionectomy, various T-levels

Who's who of ETS Telaranta, Lin, Reisfeld, Garza, Nielson, Fischel, Drott, Claes, Meyer, et al

Glossary of terms ETS, ESB, ETS-C, compensatory hyperhidrosis,

Number of surgeries

As for the amount of surgeries performed all I could find is this link [1] "Several thousand procedures are performed on a yearly basis worldwide"--Clawed 08:31, 19 Nov 2004 (UTC)

Disorder?

considers ETS to be a "nerurocardiologic disorder"

How could the NIH consider the ETS procedure to be a a disorder? Do they consider the results of the procedure to be a disorder? If so, we need a link to support that claim. AxelBoldt 19:28, 13 Feb 2005 (UTC)

I searched and searched and found nothing to back that statement up. I will remove it from the article. If by chance someone does find something to back up this claim they can add it back to the article--Clawed 10:57, 14 Feb 2005 (UTC)

I, Alexander Baker (songboy1234), an ETS surgery patient, was studied under the autonomic failure protocol of David Goldstein, M.D. Ph.D. in Nov 2004 at the National Institute of Neurological Disorders and Stroke. Many other ETS patients have been through it as well. While there, I was given a book listing all the reasearch programs at NIH. Sympathectomy is listed right along side Parkinson's disease, etc as a "neurocadriologic disorder". See a scan of the book cover and relevant page here http://www.truthaboutets.com/Pages/NIH.html

69.228.47.7 16:07, 6 August 2005 (UTC)

hidrosiscure site

I removed the 5 links to http://www.hidrosiscure.com/index.htm

I don't know who is behind this site, but it is idiotic, e.g. "Sympathectomy is sometimes used to treat facial sweating, although most patiets don't respond wel to the idea of having surgery perfomed on their face. " 69.228.47.7 16:07, 6 August 2005 (UTC)

A surgeon or somebody working for this surgeon (Reisfeld) keeps inserting links to his website: ^ "The Center for Hyperhidrosis. Dr. Reisfeld, world renowned expert and pioneer, can help! This person is promoting/selling his procedure and has no place on wiki. None of the material he would publish could be called 'objective' or 'evidence'. Unless it is evidence that he is trying to get even more people to have a surgery done by him. Stop advertising here, it will monitored and deleted. Porcelina81 (talk) 07:31, 18 January 2009 (UTC)

Comment

This article is a great example on why you can't trust Wikipedia articles. Please read the scientific literature on the topic instead. I corrected some of the many errors in the text (most notably the claim that "..Swedish medical authorities have not allowed ETS in Sweden since 2003." which simply is not true), but text is still quite bad and erroneous. Souggy (talk · contribs)

Swedish Health Authorities have indeed banned ETS in Sweden since 2003, Drs. Claes and Drott now operate in other countries. I have reinstated a mention of this, and added mention of the partial ban in Taiwan.

Please let us know Souggy what statements you find erroneous. They should be corrected.

A study has found that Wikipedia " is about as accurate on science as the Encyclopedia Britannica" http://news.bbc.co.uk/2/hi/technology/4530930.stm

Please define 'scientific literature', so that we are clear on that. The 'scientific' literature published by the surgeons who offer the surgery or the 'scientific' literature of those who investigate the various effects of sympathectomy but do not offer the procedure commercially? Very different statements are being made by these. Which one is scientific?('Porcelina81 (talk) 02:53, 1 November 2008 (UTC)',,)

Website

A spammer keeps on inserting a website that consists entirely on a sparsely visisted forum. Contains no information. I see no reason to allow this link. JFW | T@lk 19:07, 18 January 2006 (UTC)

External links

I see a very active external links section, but the negative information in the article is not actually traced back to any source. That's worrying. JFW | T@lk 18:57, 23 January 2006 (UTC)

I have added a link in the Risks and controversy section. —Preceding unsigned comment added by 86.16.47.249 (talk) 21:44, 12 June 2008 (UTC)

Left cardiac sympathetic denervation / bilateral thoracoscopic sympathectomy

Usage of "left cardiac sympathetic denervation" and "bilateral thoracoscopic sympathectomy" as treatments for Long QT syndrome and catecholaminergic polymorphic ventricular tachycardia should be more thoroughly explained here.   — C M B J   22:57, 17 December 2008 (UTC)

External links

Wikipedia is not an advertising opportunity for chat boards, your blog, or your favorite advocacy website. I've removed the most obvious violations, and ask that you please read the rules before adding any more links. WhatamIdoing (talk) 00:09, 19 January 2009 (UTC)

P.S.: "It's helpful for patients" is also not an acceptable rationale for adding prohibited types of links. Wikipedia is not written for patients. WhatamIdoing (talk) 00:09, 19 January 2009 (UTC)

You say that wiki is not for selfpromoters, then please stop inserting a link to a surgeons website who's main source of income is derived from this procedure and adding praising comments about his revolutionary...procedure. How would you know, unless... It is interesting to note, that you only removed the websites - that were clearly under the ANTI ETS banner- that contained substantial scientific evidence and collections of articles from the medical journals that prove the many adverse effects of this destructive procedure! The purpose of those websites is to get the information out to those who are considering the surgery and do not get the information from the surgeon. They do not promote or sell. It is an elective surgery...as you know. For some strange reason (?) websites that do not contain - or very little - actual scientific evidence, only complaints from patients (they can not substantiate as they do not have the facts and often might sound outrageous and quite unbelievable to the uninitiated) are left on the page. The same rule applies to these external links, but these did not bother you so much. Why is that?!! People should be warned about the possible outcomes of the procedure, and at the same time information should be substantiated. This happens with the material I have posted. Wiki posting should be based on science and not vague sentiments like "mainstream experts believe". It is weasel talk and should be eliminated. Show me the facts. Independent, trials and studies, not what the surgeons who offer the surgery publish. It is not evidence. It is self-promotion.

It is unacceptable that you delete EVIDENCE and warning aboyt the procedure that has been published in a major medical journal, and I will request that your actions are reviewed. Here is what you have deleted: A news release published by John Wiley & Sons on the 5th of February 2004: "Lifestyle' Surgical Procedure Carries Unrecognized Risk of Complications".[http://goliath.ecnext.com/coms2/gi_0199-103675/Complications-of-procedure-to-correct.html Porcelina81 (talk) 02:17, 19 January 2009 (UTC)

I'm afraid that I, too, am guilty of deleting that. However, please read what I've put in its place.

Dissatisfied with the source, which was a report of a news article about a journal article, I went looking for something in 2004 that might resemble a reliable tertiary source. Here's what I found: Ojimba, TA. "Drawbacks of endoscopic thoracic sympathectomy". British Journal of Surgery. 91 (3). John Wiley & Sons: 264–269. doi:10.1002/bjs.4511. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

I then expanded on the main points in the abstract from that source, which I believe are worth serious consideration. It is not all rosy and surgeon promoting by any means! I feel that this is what we're after on a Wikipedia article: write text, and reference it with a good source. I hope by doing this I have included information that you wanted in the article, albeit in a more encyclopaedic fashion. Cheers, Basie (talk) 05:06, 19 January 2009 (UTC)

Porcelina, I'm mystified by your complaint about the external links that I left in. Everything in ==External links== is now (as far as I could tell from a brief glance) anti-surgery. In fact, I added the anti-surgery 'banner' so that readers would know what they were looking at.

As for your recent edits: this is supposed to be an encyclopedia article. "Click on the press release!" is not proper content for an encyclopedia article. Don't provide links in the text: provide general statements, and add the links (or other sources) as <ref>erences at the end of the sentence.

Also, while we're on the topic, press releases are lousy sources. You might want to read about Wikipedia's (relatively recent) standards for reliable sources in medicine-related articles. WhatamIdoing (talk) 06:34, 19 January 2009 (UTC)

No need to be mystified. If you are so much against including links to forums, blogs, networking sites etc, - as it seems to be the policy within wiki - why would you only delete the links that took the reader to websites that include nothing but excerpts from the medical journals that were a clear statements/studies into the effects of sympathectomy. Surely those would have had a bigger impact on anyone interested in the subject than the websites you left in, where anonymous folk air their grievances, which would have no credibility to the average reader. This inconsistency - deleting the factual sites and leaving the ones with a lesser impact - indicates a clear bias, there is not other way to look at it. If the policy is to be followed than let's delete all the external links. All comments I have taken on and will endeavor to follow wiki's policies.

PS: when I added the link to the sympathectomy blog I did not intend to hijack the readers and dump more of my own writing on them. The blog is a collection of articles from the medical journals, and it was set up to counter the enourmous amount of information or advertising that is presented by surgeons who offer the surgery. You would be appalled to find the misleading statements, half-truths and lies you would find there. I have a collection of those as well. You have to keep in mind that it is an elective surgery and there are centers set up to perform mainly this procedure. They usually have aggressive campaigns that includes reliance on the media. The surgeon you are inserting on and off here with links to his website is one of the most aggressive of them. He published his article [2], insisting that insurance companies should not require other, non-surgical treatments before the patient can undergo sympathectomy. From a medical professional to advocate surgery as a first line treatment - especially when there are other means to address the condition is highly questionable - professionally and ethically, if you ask me.

Also: the blog has been reported to google as 'objectionable' content. It is being addressed, but in the meantime if you search sympathectomy, the blog will not appear among the search results. One has a chance to see it only if they have the blog address. Now who else would be upset by the collection of articles from the best medical journals than those who feel that it might hurt their interest. People are not told what this surgery does, and it appears that many do not even want the patients to know if it might hurt them financially.Porcelina81 (talk) 00:21, 20 January 2009 (UTC)

I gave a specific reason for the removal of each and every external link that did not comply with Wikipedia's standards for external links. I make no assertion that the others are appropriate, desirable, or otherwise worth keeping; I only removed those whose non-compliance with policy was patently obvious. If you think the others are equally bad, then please feel free to delete everything under the ==External links== header (including the header, if nothing is being kept).

Blogs, for example, are prohibited under WP:ELNO #11 unless you are a widely recognized expert in the field. Are you a widely recognized expert? (The minimum standard for "widely recognized expert" requires that you personally be a notable enough person in that field to have a Wikipedia article on yourself. It doesn't sound to me like you are such an expert. (Additionally, you're never allowed to add your own website, because of the conflict of interest rules.)

Do you have any further questions about why your blog and the other links do not comply with Wikipedia's standards for external links? WhatamIdoing (talk) 03:02, 20 January 2009 (UTC)

P.S. Note please that this conversation is specifically about the list under ==External links== at the very end of the article, and not about the reliable sources that appear under a ==References== or ==Notes== heading and were used to support specific issues of content in the article itself.

Is there any difference in expectations of reliability? I noted Reisfeld is back. So I assume your P.S. is there to justify that. There is no doubt in my mind that you represent Reisfeld and his interests, there is not other explanation for your repeated mention of his articles and business. I see it as advertising, and should not be permitted/tolerated on wiki. P.S. What is 'experimental measurement'? How can a measurement be experimental? Your reasoning in respect to the links I included is seriously flawed. I lost interest in this - pointless - discussion with you, however I will monitor the pages that are a possible advertising banner for the unscrupulous. Porcelina81 (talk) 19:51, 21 January 2009 (UTC)

Oh, yes, the rules are entirely different for the two sections. WP:External links permits much more than WP:Reliable sources.

I'm not sure what your question about 'experimental measurement' refers to. WhatamIdoing (talk) 22:02, 21 January 2009 (UTC)

I blanked the External links section. Seemed a collection of patient advocacy sites and 2 links to mayo clinic and another similar (we should be giving better coverage than those). The bot reverted I think because one of the links has "blog" in the domain. None of these external links were very useful, and most where positively unencyclopedic. Lesion 20:07, 18 April 2014 (UTC)

History

Much of the history section can be sourced to:

• Shields, Thomas W. (2005). General thoracic surgery. Hagerstown, MD: Lippincott Williams & Wilkins. p. 2466. ISBN 0-7817-3889-X.

The relevant page is visible at Google Books. WhatamIdoing (talk) 18:34, 20 January 2009 (UTC)

No-ets.com is not a reliable source

I have repeatedly removed "no-ets.com" from the middle of this article. Supposedly, it's being used to support a fact in the article (the number of surgeries performed). It has two major problems:

1. Every other source is enclosed in <ref> tags and listed in references. The format of this link is simply not acceptable under the relevant guidelines.
2. The website and webpage do not meet Wikipedia's standards for reliability. No-ets.com is a biased, outdated, unreliable, personal website. Many of the names are listed as solely "my estimate" -- a guess from a single non-expert individual -- which is not a sufficient way of determining this information anyway. It was last updated in 2006 and covers only a handful of selected surgeons. There is no reason to think that the list is either complete or unbiased.

If this webpage is considered necessary to support an unimportant fact, then the fact itself can be deleted. WhatamIdoing (talk) 16:51, 24 April 2009 (UTC)

The difference between upper back and lower back

A persistent, but unfortunately misguided, editor has repeatedly added incorrect information to this article. The misunderstanding appears to be due to a lack of basic anatomical information. To the right, you will see an image that shows the different parts of the human spine. The thoracic (chest) vertebrae are in the upper-middle section. There are twelve of them, and ETS usually involves a couple of the top five. Below that, you will find the lumbar (low back) vertebrae. There are five of them, and ELS usually involves the space between the third and fourth of those five.

The side effects that you get from E-thoracic-S are not the same that you get from E-lumbar-S, because the different surgeries cut very different nerves. The sexual side effects that have been persistently added to this article do not happen in E-thoracic-S. The named source specifically says that it's about E-lumbar-S. Please quit adding this outright error to this article. WhatamIdoing (talk) 16:59, 24 April 2009 (UTC)

Just to clear it up: If you have not studied the ANS, you will make the error of thinking that the SNS is anatomically clearly defined, exact and injury (surgical in this case) to the sympathetic chain will only affect a well defined 'segment' of the chain and the body. That is a common misconception and can be easily dismissed by quoting from the many surgeons who offer this procedure. After all they had the opportunity to observe the incorrectness of this ...assumption. They publish articles in the medical journals, where they describe cervico-thoracic sympathectomy affecting temperature and sweating of the feet (!) (in one article in as many as 70% of the patients). If you perform a brief search of the literature, you will find that peripheral denervation/sympathectomy will result in CNS activation. Sympathectomy has a systemic, overall effect on the functioning/balance of the ANS/body. And if you google 'effect' and 'sympathectomy' you will also find that it affects far more than sweating on a small body surface/area - which is a common sales pitch by the ETS surgeons, but can not be supported by evidence - so that kind of pseudoscience has no place on wiki. Sympathectomy, even cervical or high-thoracic can affect sexual function, and also it can affect/alter digestion, immune responses, fatty deposits in connective tissue, bone resorption, synovial fluid etc etc. Pls use google..or PubMed... If you are in doubt about the local - systemic effect of sympathectomy, please ask someone who is trained within the field. (porcelina81, who could not find her password to log in) —Preceding unsigned comment added by 114.73.23.180 (talk) 08:19, 25 October 2010 (UTC)

If you can't find a high-quality source that says e-thoracic-s causes sexual side effects, then we're not including the information. I don't care what your personal theory is. Wikipedia includes information that is WP:Verifiable and reflects the balance of reliable sources, not information that one individual personally believes to be true. The rule is verifiability, not Truth™. WhatamIdoing (talk) 17:27, 2 August 2011 (UTC)

There's a high-quality source that confirms a lawsuit regarding sexual side effects.

http://www.theargus.co.uk/news/1720772.blushing_op_ruined_my_sex_life_man_claims/

Might be worthy to include mention patient's claim and lawsuit. I haven't found any denial of the sexual effects, but if a high-quality source can be found for the denial, I'd support including that too. — Preceding unsigned comment added by 24.24.174.205 (talk) 23:52, 28 June 2013 (UTC)

Merge with sympathectomy?

I'm wanting to remove some material from this article relating to sympathectomy in general, not specifically to ETS. I notice that sympathectomy appears to be a stub at this time. — Preceding unsigned comment added by 24.24.174.205 (talk) 23:42, 28 June 2013 (UTC)

Seems that there is also such a thing as cervical and lumbar sympathectomy. I take it that thoracic sympathectomy is the most commonly performed of these. Furthermore, this article specifies endoscopic, which narrows the scope even more if there are other techniques. According to a cochrane review, sympathectomies can be performed open, endoscopically, or with laser, radiofrequency, or ablation. Lesion 18:37, 18 April 2014 (UTC)

Edit Warring over External Links

I think it is proper to re-instate at least some of the recently deleted external links. http://corposcindosis.blogspot.com/ is not a "patient advocacy" site, nor am I aware that that is relevant in any case. Rather, it appears to be a site dedicated to "The Effects of Thoracic Sympathectomy in Humans", the very subject of this article. The "references" tab appears to lead to a great number of citations, most in the "mainstream" literature. Further, following the links in the article, I note that medical doctor Pascal Dumont has referenced the cite in his mainstream article.

The Mayo Clinic and University of Maryland are hardly "patient advocacy" sites.

24.24.174.205 (talk) 22:06, 20 April 2014 (UTC)

Here is language from http://en.wikipedia.org/wiki/Wikipedia:EL, about external links which can be included:

Sites that contain neutral and accurate material that is relevant to an encyclopedic understanding of the subject and cannot be integrated into the Wikipedia article due to copyright issues,[3] amount of detail (such as professional athlete statistics, movie or television credits, interview transcripts, or online textbooks), or other reasons.

24.24.174.205 (talk) 02:14, 21 April 2014 (UTC)

Let's also consider the language from WP:ELNO#EL11, which insists that we avoid "Blogs, personal web pages and most fansites". Blogspot is not exactly the most obvious place for a "scientific website", even if we accepted that a website on that subject belonged here and not in the article about subject. WhatamIdoing (talk) 02:04, 19 June 2015 (UTC)

Hi. I have had my link removed to www.etssurgeryawareness.org which is a cited source of information. Please can I ask why?

I wrote. "Also, a website 'ETS Surgery Awareness' has been created which includes patients detailing their side-effects." Why has this been removed. It's very useful information. CathF83 (talk) 21:27, 16 September 2022 (UTC)

For reference, see this discussion at my talk page for my thoughts on why I removed the paragraph. It can be summed up as a case of WP:Advocacy. Isabelle ^🏳‍🌈 23:51, 16 September 2022 (UTC)