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.
First rib resection is indicated for venous, arterial and neurogenic TOS. Scalenectomy may be additionally indicated in venous and neurogenic TOS.
The first rib may be approached several different ways: from above the clavicle in a inferior direction, from the posterior neck, and from the armpit medially.