First Rib Resection: A Novel Video Assisted Thoracoscopic Minimally Invasive Approach to the Management of Thoracic Outlet Syndrome

Harmik J Soukiasian, MD, Ankur Gupta, MD, George Berci, MD, Robert J McKenna, MD. Cedars – Sinai Medical Center, Division of Cardiothoracic Surgery

INTRODUCTION: With the failure of medical management of Thoracic Outlet Syndrome, surgical intervention is indicated. The surgical management of Thoracic Outlet Syndrome has been dominated by the use of either a supraclavicular or transaxillary approach to first rib resection. There has been little reported on the use of a video assisted thoracoscopic (VATS) approach to first rib resection. OBJECTIVE: Demonstrate the feasibility and safety of a minimally invasive thoracoscopic (VATS) approach to first rib resection. METHODS: Between 2001 and 2010, 57 patients (40 women, 17 men) with thoracic outlet syndrome (TOS) underwent VATS first rib resection. RESULTS: Forty patients were females (70%) and mean age was 41 (22-59) years-old. There were no deaths. The mean length of stay was 2.6 days. Complications occurred in 5 patients (8.8%); wound infection (3), pneumothorax (1), aspiration pneumonia (1), and temporary arm weakness (1). CONCLUSIONS: Video assisted thoracoscopic surgery (VATS) for thoracic outlet syndrome provides an attractive and safe operative approach for first rib resection.

Session: Emerging Technology Poster
Program Number: ETP042
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