Technical Adaptation of First Rib Resection by Vats for the Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is not common in the thoracic surgeon´s routine. However, when it is encountered, it is important that the correct diagnosis and treatment is carried out, especially as surgery can be indicated in cases of non-clinical improvement. The goal of the surgery is to release the thoracic outlet constriction structures, which can be performed by several approaches. The innovative VATS surgical technique described here allows better rib exposure, the use of blunt digital dissection, as well as a new device for rib cutting. The technique described here has proven to be feasible, safe and reproducible.