Surgical Techniques: Operative Decompression Using Thoracoscopic Approach for Neurogenic Thoracic Outlet Syndrome

First rib resection is commonly performed for patients with neurogenic thoracic outlet syndrome. A variety of approaches to this operation have been described including supraclavicular, infraclavicular, paraclavicular, and transaxillary approaches. In recent years, thoracoscopic approaches including thoracoscopic assisted transaxillary, thoracoscopic transthoracic, and robot-assisted transthoracic approaches to first rib resection have been described. In this chapter the rationale, advantages and disadvantages, and short-term outcomes of thoracoscopic first rib resections for neurogenic thoracic outlet syndrome are presented.