First rib resection using videothorascopy for the treatment of thoracic outlet syndrome.

OBJECTIVE: Thoracic outlet syndrome is a condition caused by compression of the subclavian artery, subclavian vein and/or the brachial plexus. Scalene muscle section and first rib removal is the most effective treatment. The objective of this article is to demonstrate first rib resection using videothoracoscopy. TECHNIQUE: We describe first rib removal by videothoracoscopy using three 12 mm entrance ports (although one is widened to 3 cm to introduce periosteotomy cutters and rib shears). We have performed this operation on three cases of thoracic outlet syndrome with very good results.
CONCLUSIONS: Removal of the first rib by videothoracoscopy is a viable and very aesthetic technique with a low morbidity. It is a very good option for the majority of patients affected by this syndrome, particularly in obese patients or those with Pager-Schroetter syndrome.