First rib resection
| First rib resection | |
|---|---|
| Specialty | Vascular Surgeon |
First rib resection is a surgical procedure used in humans to treat thoracic outlet syndrome (TOS) and Paget–Schroetter disease. 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
chest wall and the clavicle, through which the subclavian vein, 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
anterior scalene muscle (scalenectomy) and freeing up scar tissue around the subclavian vein (venolysis) are often also performed. If anomalous cervical
ribs are present, these may be removed as well.