Transthoracic Robotic First and Cervical Rib Resection for Thoracic Outlet Syndrome.


Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
01 Jun 2023
Historique:
medline: 29 11 2023
pubmed: 2 10 2021
entrez: 1 10 2021
Statut: ppublish

Résumé

Neurogenic thoracic outlet syndrome (TOS) is a musculoskeletal condition in which the brachial plexus is dynamically compressed within the scalene triangle, an anatomic space bordered by the anterior and middle scalene muscles and the first rib. In some cases, an offending cervical rib is present. Traditional surgical approaches to first rib resection and scalenectomy are limited by exposure, require retraction of neurovascular structures, and result in morbidity. We describe a novel transthoracic robotic approach to first/cervical rib resection that overcomes these limitations, and we review its early clinical outcomes. Robotic first rib resection (FRR) is crystallized into 12 distinct steps, each with detailed video commentary, and nuances specific to neurogenic and venous TOS cases are provided. Published data supports decreased surgical morbidity of robotic FRR compared with open cases. Robotic FRR offers advantages over traditional operative approaches including improved exposure and elimination of retraction of neurovascular structures, which result in improved safety.

Identifiants

pubmed: 34596078
doi: 10.1097/SLA.0000000000005232
pii: 00000658-900000000-93262
doi:

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1215-e1216

Informations de copyright

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest

Références

Sanders RJ, Hammond SL. Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. J Vasc Surg. 2002;36:51–56.
Ferguson TB. The crisis of excellence. J Thorac Cardiovasc Surg. 1982;84: 161–171.
Burt BM, Palivela N, Cekmecelioglu D, et al. Safety of robotic first rib resection for thoracic outlet syndrome. J Thorac Cardiovasc Surg. 2020;162:1297–1305.e1.
Gharagozloo F, Meyer M, Tempesta B, et al. Robotic transthoracic first-rib resection for Paget-Schroetter syndrome. Eur J Cardiothorac Surg. 2019;55:434–439.
Palivela N, Lee HS, Jang HJ, et al. Improvement of disability in neurogenic thoracic outlet syndrome by robotic first rib resection. Ann of Thorac Surg. 2022;114:919–925.
Illig KA, Donahue D, Duncan A, et al. Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome. J Vasc Surg. 2016;64:e23–e35.

Auteurs

Nihanth Palivela (N)

Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.

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Classifications MeSH