First rib resection: Difference between revisions
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A '''First rib resection''' is a [[surgery|surgical procedure]] used in humans to treat [[thoracic outlet syndrome]] (TOS). It is often accompanied by scalenectomy, or removal of the nearby [[Scalene muscles|anterior scalene muscle]]. It involves the [[surgery|surgical]] removal of a segment of the first rib, which is the rib closest to the head, under the [[clavicle|collar bone]] |
A '''First rib resection''' is a [[surgery|surgical procedure]] used in humans to treat [[thoracic outlet syndrome]] (TOS). It is often accompanied by scalenectomy, or removal of the nearby [[Scalene muscles|anterior scalene muscle]]. It involves the [[surgery|surgical]] removal of a segment of the first rib, which is the rib closest to the head, under the [[clavicle|collar bone]]. |
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==Indications== |
==Indications== |
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Revision as of 18:26, 11 June 2021
| First rib resection | |
|---|---|
| Specialty | Vascular Surgeon |
A First rib resection is a surgical procedure used in humans to treat thoracic outlet syndrome (TOS). It is often accompanied by scalenectomy, or removal of the nearby anterior scalene muscle. It involves the surgical removal of a segment of the first rib, which is the rib closest to the head, under the collar bone.
Indications
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First rib resection is indicated for venous, arterial, and neurogenic TOS.[1] Scalenectomy may be additionally indicated in venous and neurogenic TOS. In all cases, the goal of the operation is to increase the dynamic space between the chest wall and the clavicle, through which the subclavian nerve, artery, and the brachial nerve roots pass. [2]
Procedure
The first rib may be approached several different ways: from above the clavicle in an inferior direction (infraclavicular), from above the clavicle (supraclavicular), from the posterior neck, and from the armpit medially (transaxillary).
While the operation universally involves removal of the first rib, depending on the indication for the operation, additional maneuvers may be performed. For venous thoracic outlet syndrome, removal of anterior scalene muscle (scalenectomy) and freeing up scar tissue around the subclavian vein (venolysis) are often also performed.
References
- ^ Brooke, Benjamin; Freishlag (2010). "Contemporary management of thoracic outlet syndrome". Curr Opin Cardiol. 25 (535–540): 535–40. doi:10.1097/HCO.0b013e32833f028e. PMID 20838336.
- ^ Jones, MR; Prabhakar, A; Viswanath, O; Urits, I; Green, JB; Kendrick, JB; Brunk, AJ; Eng, MR; Orhurhu, V; Cornett, EM; Kaye, AD (June 2019). "Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment". Pain and therapy. 8 (1): 5–18. doi:10.1007/s40122-019-0124-2. PMID 31037504.