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Updated: Apr 18, 2026
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Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
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A video-assisted thoracoscopic approach to transaxillary first rib resection
Harmik J Soukiasian1, Daniel Shouhed, Derek Serna-Gallgos
1From the Division of Thoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Innovations (Philadelphia, Pa.)
|February 3, 2015
Summary
Video-assisted thoracoscopic surgery (VATS) provides a feasible minimally invasive option for treating thoracic outlet syndrome (TOS) when conservative methods fail. This approach demonstrates outcomes comparable to traditional surgical techniques.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Procedures
- Vascular Surgery
Background:
- Thoracic outlet syndrome (TOS) presents with neurologic, arterial, or venous symptoms.
- Surgical intervention is considered when conservative TOS treatments are ineffective.
- Traditional first rib resection approaches include supraclavicular and transaxillary methods.
Purpose of the Study:
- To describe a minimally invasive surgical approach for TOS using video-assisted thoracoscopic surgery (VATS).
- To report the outcomes associated with VATS first rib resection for TOS.
Main Methods:
- Retrospective analysis of a prospectively maintained database.
- Inclusion of patients with TOS who failed non-surgical therapy.
- Performance of 66 VATS first rib resections on 58 patients between 2001 and 2010.
Main Results:
- The study included 58 patients (41 women, 17 men) with a mean age of 40.5 years.
- The average hospital stay was 2.47 days, with a median of 2 days.
- A total of 8 complications (12.1%) were reported, with no mortalities.
Conclusions:
- Video-assisted thoracoscopic surgery (VATS) first rib resection is a viable surgical option for managing TOS.
- The outcomes of this minimally invasive VATS technique are comparable to established surgical standards of care for TOS.
