Minimally invasive first rib resection: a technique that is here to stay

Thoracic outlet syndrome (TOS) effects approximately 8% of the population and although conservative management consisting of physiotherapy and avoidance of maneuvers that exacerbate the symptoms is usually successful, 5% of patients diagnosed with the disease will have persistent symptoms and need to undergo an operation to cure their disease. Several approaches to resect the first rib and cervical ribs have been described including the supraclavicular, infraclavicular, transaxillary, high posterior thoracoplasty incision and more recently minimally invasive video assisted techniques.