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

Authors :
Gharagozloo F
Meyer M
Tempesta BJ
Margolis M
Strother ET
Tummala S
Source :
Innovations (Philadelphia, Pa.) [Innovations (Phila)] 2012 Jan-Feb; Vol. 7 (1), pp. 39-44.
Publication Year :
2012

Abstract

Objective: 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.<br />Methods: 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.<br />Results: 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%.<br />Conclusions: 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 complications that are associated with conventional techniques.

Details

Language :
English
ISSN :
1559-0879
Volume :
7
Issue :
1
Database :
MEDLINE
Journal :
Innovations (Philadelphia, Pa.)
Publication Type :
Academic Journal
Accession number :
22576034
Full Text :
https://doi.org/10.1097/IMI.0b013e3182542ab3