Surgeons in green scrubs performing Endoscopic thoracic sympathectomy (ETS) surgery in an operating room

RA Fischer's 'The Fischer'
vs. ETS Surgery

Endoscopic Thoracic Sympathectomy (ETS) surgery is viewed as a final option for hyperhidrosis treatment.

This surgical procedure is invasive, especially for axillary hyperhidrosis patients, where the surgeon may need to deflate your lung to sever the sympathetic nerve. Yes, you read that correctly - deflate your lung.

Now, let's think about how this compares to the non-invasive, at-home iontophoresis method.
Close-up photograph of the white water bath trays for RA Fischer's "The Fischer" Device with ph-balancing foam inside the tray. It is sitting on a flat wooden surface


Consider this scenario: You seek medical help for excessive hand sweating and opt for ETS surgery. The outcome seems promising – your hands no longer sweat profusely. However, there’s an unexpected issue: compensatory sweating. This condition means that now you experience excessive sweating in other parts of your body.


Our Treatment Specialists at RA Fischer Co. have encountered numerous patients who regret their decision to undergo ETS surgery. In contrast, iontophoresis is non-surgical, with no serious side-effects and no compensatory sweating.

In a comfortable home environment, a young woman with brown hair sits with a warm smile while effectively managing her palmar (hands) hyperhidrosis (excessive sweat) using RA Fischer Co.'s original metal-free iontophoresis device, "The Fischer." Her hands are comfortably placed within the white water bath trays containing blue pH-balancing foam, along with silicone-graphite electrodes, providing a comprehensive and innovative solution for her condition.


ETS surgery entails a procedure aimed at disrupting the transmission of nerve signals from sympathetic ganglia, which send fibers to the sweat-producing areas.


Surgeons achieve this by either eliminating the ganglia or severing the sympathetic trunk, using techniques such as electrocautery or laser surgery.

Surgeons in green scrubs performing Endoscopic thoracic sympathectomy (ETS) surgery in an operating room

Now compare this to RA Fischer Co.’s iontophoresis treatment, which simply requires placing your hands in two trays of water for 15-20 minutes. No surgeons, hospitals, or recovery required. 

"The most invasive treatment for hyperhidrosis is the surgical interruption of the thoracic sympathetic chain, a procedure done with the goal of permanently stopping sweating in the area innervated by the involved ganglia. Sympathectomy has been shown to be very effective for palmar sweating, but is less effective for axillary symptoms. Although now done as a minimally invasive technique using video-assisted endoscopy, the procedure is still associated with complications that lead most clinicians to reserve this procedure for patients with severe symptoms who have failed to improve with more-conservative treatment."

lifestyle impact and risks of ets surgery

Beyond the financial burden, let’s talk about the toll ETS surgery can take on your lifestyle.


Randy Choi, co-founder of the Thompson Tee, discusses his experience on his company’s website. He lists compensatory sweating (aka sweating in new places), psychological fatigue, skin problems, and slowed metabolism among the chief side-effects he experienced.

Image of four men playing basketball near the ocean

Many individuals who undergo ETS surgery often report experiencing significant and life-altering complications. Other than compensatory sweating, ETS surgery can change bodily functions such as: 


The ETS procedure is surgery, which means it is inherently expensive. You may anticipate that your insurance will shoulder the expenses, but insurance providers will typically insist on exhausting every other available treatment option before considering surgery as a covered option.

The Fischer iontophoresis device is a one-time investment, often  covered through insurance, with long-lasting results. Our flexible financing options allow you to cover your patient responsibility over time. Talk to our Treatment Specialists about your retail options, too.


The Fischer iontophoresis device is a one-time investment, often  covered through insurance, with long-lasting results.

Plus, you’ll get all the tools you’ll need – from tutorial videos to the support of your personal Treatment Specialist – to ensure you become one of the 98% of people who see success with iontophoresis treatment.


Reach out today

Contact one of our Treatment Specialists today to answer any and all of your questions about the Fischer. 

Is the Fischer right for you?

Compared to narrow metal electrodes or compact iontophoresis options, the proportions of The Fischer’s water bath trays, pH-balancing foam inserts, and silicone-graphite electrodes conveniently accommodate simultaneous treatment of hands and feet without sacrificing effectiveness.

Our Fischer boasts a 98% success rate for patients! Reach out to a Treatment Specialist today to learn more and check your insurance coverage.

A young woman with brown hair standing at a table in a cozy-looking home. She is smiling and opening a box for RA Fischer Co.'s "The Fischer" iontophoresis device, made for treating hyperhidrosis (Excessive sweating).

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