Our Summary

Thoracic Outlet Syndrome (TOS) is a medical condition where the space between the collarbone and first rib becomes narrow, causing pressure on the nerves and blood vessels going to the upper arm. This condition might be more common than we think, as it’s hard to diagnose without thorough testing. One way to treat TOS is by removing the first rib, and in recent years, doctors have started using robots to help with this surgery.

Researchers looked back at the medical records of patients who had this type of surgery at Lucerne Cantonal Hospital. They also reviewed existing research papers on the topic. Between June 2020 and November 2021, eleven patients had the robot-assisted rib removal surgery at the hospital. On average, patients stayed about two days in the hospital and the surgery took about three hours. No complications occurred during the surgeries.

The researchers concluded that using robots to assist in removing the first rib could be a safe and effective treatment for TOS, as long as it’s done by an experienced surgeon.

FAQs

  1. What is Thoracic Outlet Syndrome (TOS) and how is it treated?
  2. How is robotic assistance used in the surgery for Thoracic Outlet Syndrome?
  3. What were the findings of the study conducted on robot-assisted rib removal surgeries at Lucerne Cantonal Hospital?

Doctor’s Tip

A helpful tip a doctor might tell a patient about thoracic outlet syndrome surgery is to follow all post-operative care instructions carefully. This may include keeping the incision site clean and dry, taking prescribed medications as directed, attending follow-up appointments, and participating in physical therapy as recommended. It’s important to communicate with your healthcare team about any concerns or changes in symptoms following surgery. With proper care and rehabilitation, patients can often experience significant relief from the symptoms of thoracic outlet syndrome after surgery.

Suitable For

Patients who are typically recommended thoracic outlet syndrome surgery are those who have severe symptoms that do not improve with conservative treatments such as physical therapy, medications, or injections. These symptoms may include:

  • Numbness or tingling in the arm or fingers
  • Weakness in the arm or hand
  • Pain in the shoulder, arm, or neck
  • Swelling or discoloration of the arm or hand
  • Difficulty lifting or carrying objects

Patients with a confirmed diagnosis of thoracic outlet syndrome based on physical examination, imaging studies, and nerve conduction tests may be candidates for surgery. It is important for patients to discuss the risks and benefits of surgery with their healthcare provider to determine if it is the right treatment option for them.

Timeline

Timeline:

Before Surgery:

  1. Patient experiences symptoms such as pain, numbness, and weakness in the arm, shoulder, and hand.
  2. Patient undergoes diagnostic tests such as MRI, CT scan, and nerve conduction studies to confirm the diagnosis of TOS.
  3. Patient discusses treatment options with their healthcare provider, including the possibility of surgery.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are fit for surgery.

After Surgery:

  1. Patient is admitted to the hospital for the surgery and stays for an average of two days.
  2. Surgery is performed using robot-assisted technology, taking about three hours to complete.
  3. Patient is closely monitored for any complications post-surgery.
  4. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the affected arm.
  5. Patient follows up with their healthcare provider for regular check-ups and monitoring of their recovery progress.
  6. Patient experiences relief from symptoms and improved quality of life after successful surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thoracic outlet syndrome surgery include:

  1. What are the potential risks and complications associated with robot-assisted rib removal surgery for thoracic outlet syndrome?
  2. How experienced are you in performing this type of surgery, and how many procedures have you done?
  3. What is the success rate of robot-assisted rib removal surgery for thoracic outlet syndrome?
  4. What is the recovery process like after the surgery, and how long will it take to fully recover?
  5. Are there any alternative treatment options for thoracic outlet syndrome that I should consider?
  6. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?
  7. How long will I need to stay in the hospital after the surgery, and what can I expect during my hospital stay?
  8. What kind of follow-up care will be needed after the surgery, and how often will I need to see you for check-ups?
  9. Are there any lifestyle changes or restrictions I should be aware of after the surgery?
  10. What can I do to prepare for the surgery and optimize my recovery outcomes?

Reference

Authors: Gkikas A, Lampridis S, Patrini D, Kestenholz PB, Azenha LF, Kocher GJ, Scarci M, Minervini F. Journal: Front Surg. 2022 Mar 8;9:848972. doi: 10.3389/fsurg.2022.848972. eCollection 2022. PMID: 35350142