Robotic en bloc first-rib resection for Paget-Schroetter disease, a form of thoracic outlet syndrome: technique and initial results

Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery
Farid GharagozlooSrini Tummala

Abstract

First-rib resection is a key component of the treatment of Paget-Schroetter disease. There are many controversies regarding the management of this disease. We report a safe, effective, minimally invasive robotic transthoracic approach for resection of the first rib. Over an 8-month period, five patients underwent robotic first-rib resection. Preoperative assessment included physical examination and bilateral venous angiography. On a thoracoscopic platform using three 2-cm incisions and one 1-cm incision, the robot was used to dissect the first rib and divide the scalene muscles. Success of the first-rib resection was assessed by postoperative venous angiography. There were four men and one woman. Mean age was 34.6 ± 10 years. Mean operative time was 195 ± 24.6 minutes. There were no complications and no mortality. All patients had a patent subclavian vein on the postoperative venogram and were anticoagulated with warfarin for 3 months. At a median follow-up of 12 months, all patients had an open subclavian vein for a patency rate of 100%. Robotic thoracoscopic first-rib resection represents a feasible minimally invasive approach to en bloc resection of the first rib. This technique minimizes the risk of neurovascular complicati...Continue Reading

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Citations

Aug 21, 2014·Minimally Invasive Surgery·Cihangir Tetik, Metin Uzun
Aug 29, 2016·Seminars in Thoracic and Cardiovascular Surgery·Scott Reznik
Mar 24, 2017·Vascular and Endovascular Surgery·Joseph M White, Anthony J Comerota
May 31, 2017·Diagnostics·M Libby Weaver, Ying Wei Lum
Aug 8, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Farid GharagozlooStephan Gruessner
Apr 27, 2018·World Journal of Surgery·Gregor J KocherRalph A Schmid
Oct 23, 2020·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Elizabeth SharpMarios Loukas
May 22, 2021·Praxis·Patrick DornGregor J Kocher

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