Totally Endoscopic (VATS) First Rib Resection for Thoracic Outlet Syndrome

George, Robert S.; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

doi:10.1016/j.athoracsur.2016.06.075

Cited by 55 publications

(40 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A fi rst minimal invasive approach (VATS) has been described as well, but never gained much interest [4][5][6]. This has probably to do with the current limitations of the videoassisted thoracoscopic instrumentation, making it hard to reach the fi rst rib.…”

Section: A New Approachmentioning

confidence: 99%

Robot-assisted First Fib Resection for Neurogenic Thoracic Outlet Syndrome

Beelen¹

2019

Ann Musculoskelet Med

View full text Add to dashboard Cite

This pathophysiological mechanism forms the substrate of the surgical treatment of TOS (cf. infra). AbstractBackground: When conservative measures fail in the treatment of thoracic outlet syndrome (TOS), a fi rst rib resection (FRR) is in order. Nowadays, a transaxillary or supraclavicular approach is most commonly used. However, both techniques have technical limitations.Objective: In this paper a minimal invasive, robot-assisted thoracoscopic technique tackling those shortcomings is proposed. Methods:A single-center retrospective study including 11 patients with 12 FRR's from January 2017 until August 2018 was performed. The main focus was the feasibility of this new technique by looking at mean hospital stay, postoperative pain and complication rate. Clinical outcome was evaluated at 6 weeks.Results: Twelve FRR were performed in 10 women and 1 man. Average operative time was 99 ± 32 minutes. One patient needed chest tube replacement for pneumothorax after initial tube removal. One patient was readmitted for pleurisy which was treated conservatively. Max average pain score (VAS; visual analogue pain score) was 5. Mean hospital stay was 3.4 days. Outcome at 6 weeks' time showed a complete relief of symptoms in 8 cases. Three patients had some residual fatigue complaints. However, these complaints improved over time. In one case there was no real benefi t from the procedure. Conclusion:Robot-assisted thoracoscopic FRR is a safe and feasible method in the treatment of TOS with excellent postoperative results. A robot-assisted approach offers the benefi t of an excellent exposure of the operative fi eld and gentle handling of tissue. Further research in larger series is needed to compare this promising technique to conventional approaches.

show abstract

Section: A New Approachmentioning

confidence: 99%

Robot-assisted First Fib Resection for Neurogenic Thoracic Outlet Syndrome

Beelen¹

2019

Ann Musculoskelet Med

View full text Add to dashboard Cite

show abstract

“…Although their data include a very small group of 10 patients, they did observe complete resolution of symptoms in 90% of patients, which is comparable to the success rate of other techniques. The median operative time was 85 min, and the median post-operative length of stay was 72 h [25]. A larger study examined 58 patients undergoing 66 rib resections (eight bilateral) with a different VATS technique requiring a transaxillary incision with a single port placement just below the incision.…”

Section: Treatmentmentioning

confidence: 99%

New Diagnostic and Treatment Modalities for Neurogenic Thoracic Outlet Syndrome

Yw²

2017

Diagnostics

View full text Add to dashboard Cite

Neurogenic thoracic outlet syndrome is a widely recognized, yet controversial, syndrome. The lack of specific objective diagnostic modalities makes diagnosis difficult. This is compounded by a lack of agreed upon definitive criteria to confirm diagnosis. Recent efforts have been made to more clearly define a set of diagnostic criteria that will bring consistency to the diagnosis of neurogenic thoracic syndrome. Additionally, advancements have been made in the quality and techniques of various imaging modalities that may aid in providing more accurate diagnoses. Surgical decompression remains the mainstay of operative treatment; and minimally invasive techniques are currently in development to further minimize the risks of this procedure. Medical management continues to be refined to provide non-operative treatment modalities for certain patients, as well. The aim of the present work is to review these updates in the diagnosis and treatment of neurogenic thoracic outlet syndrome.

show abstract

“…It is an honour to be asked to write a comment on the paper by George et al (1) as I have a particular interest in the treatment of Thoracic Outlet Syndrome as I have been the main author on the most recent Cochrane review on Treatment for thoracic outlet syndrome (2).…”

Section: Dear Editormentioning

confidence: 99%