Thoracoscopic Subtotal Sympathectomy (TOSS) is a randomized, SHAM-controlled, double-blinded 24-h blood pressure-based trial in patients with primary hypertension.

Patients are eligible to be included in the study if they are treated with at least 3 antihypertensive drugs including a diuretic, if tolerated, and have 24-hour ambulatory average systolic blood pressure ≥ 150 mmHg. Patients are randomized to either thoracoscopic subtotal sympathectomy or SHAM.