High-definition video-assisted transaxillary first rib resection for thoracic outlet syndrome

Transaxillary first rib resection is a well-established effective surgical treatment for patients with symptomatic thoracic outlet syndrome, but surgical access may be limited and visualization is constrained. The use of high-definition video-assisted imaging overcomes these limitations. The use of high-definition video-assisted visualization of the anatomy enhances the surgeon's tactile feedback of the rib from the small open wound and is effective in providing better surgical access and allows clear identification of vital structures for the operating surgical team. This technique enhances the appreciation of anatomic detail, situational awareness of the team, and allows for more efficient assistance to the surgeon. Improved visualization also facilitates effective education of nurses, residents, and students. (J Vasc Surg 2013;57:1155-8.)