Spontaneous Bilateral Second Rib Fractures After Robotic Thoracic Outlet Surgery: A Rare Complication

Thoracic outlet syndrome (TOS) involves the compression of vascular or neural structures between the first rib and the scalene muscles that leads to diverse symptoms. Traditional surgical treatments include transaxillary or supraclavicular first rib resection, but robotic first rib resection is increasingly popular because of enhanced visualization of the thoracic inlet. We report a unique complication of spontaneous bilateral second rib fractures after robotic bilateral first rib resection in a 34-year-old man with neurogenic and venous TOS. As robotic TOS surgery becomes more common, recognizing the risk of spontaneous second rib fractures is crucial, particularly in patients with potentially reduced bone integrity.