An improved method of exposure for transaxillary first rib resection.

Transaxillary first rib excision, used for thoracic outlet decompression, requires that the patient be in the lateral decubitus position with the arm elevated. This is traditionally accomplished by a junior resident or medical student holding the arm in the air for the duration of the case. This technical note presents a simplified method of passive arm elevation using orthopedic techniques that provides superb exposure of this area with no appreciable patient morbidity. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.