Single port endoscopic transaxillary first rib resection for thoracic outlet syndrome

Thoracic outlet syndrome is caused by the compression of neurovascular structures in the thoracic outlet. We present an alternative approach to open treatment that uses single port laparoscopy. This minimally invasive technique allows for improved exposure and precise dissection and is more efficacious in morbidly obese patients. Additionally, this technique offers a smaller incision with the single port system and improved ergonomics with the laparoscopic instruments. In the standard open approach, it can be difficult to obtain full posterior/medial exposure safely, and there is risk of excess retraction that could result in neurovascular complications. In open approach only one person can look inside the field at any time, whereas laparoscopic visualization allows all surgeons to examine the operative field simultaneously and provide input. This novel approach represents a promising advancement in thoracic outlet syndrome management, offering patients a less invasive alternative.