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Computer-assisted instrumentation during endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe alternate approach.
Vascular 2005 Nov-Dec; 13(6):327-35V

Abstract

The purpose of this article is to discuss the feasibility of using computer-enhanced instrumentation to improve visualization and therefore patient safety during transaxillary first rib resection. From November 1998 to July 2005, 105 patients who had failed conservative treatment underwent 131 procedures for thoracic outlet decompression. Eighty-nine endoscopic transaxillary first rib resections were completed using Aesop/Hermes integrated voice control instrumentation (Computer Motion, Goleta, CA). Since February 2003, dissection in 42 procedures was performed using the daVinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA). The surgical findings with cervical bands correlated with the preoperative symptoms. One hundred percent of patients with a combination of neurogenic and arterial thoracic outlet syndrome (TOS) requiring cervical rib resection had Roos type I and/or II bands. Additional surgical findings included the following: combination of neurogenic and arterial TOS without cervical ribs or neurogenic TOS alone had type III, IV, or V bands, and patients with venous compression (100%) had type VII bands. No mortalities or permanent neurovascular injuries occurred. There was a 6.1% postoperative complication rate. Persistent myofibrositis was found in 34% of patients with ongoing symptoms.

CONCLUSION

The daVinci three-dimensional optical imaging system enhances visualization, thereby promoting telemanipulation of soft tissue structures in a relatively inaccessible working space. Endoscopic computerized instrumentation in transaxillary first rib resection decreases the risk of neurovascular injury, promotes complete decompression, and therefore provides a safe alternative to standard first rib resections.

Authors+Show Affiliations

Minimally Invasive Vascular Surgery Department, St. Vincent Mercy Medical Center, Toledo, Ohio, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

16390650

Citation

Martinez, Bernardo D., et al. "Computer-assisted Instrumentation During Endoscopic Transaxillary First Rib Resection for Thoracic Outlet Syndrome: a Safe Alternate Approach." Vascular, vol. 13, no. 6, 2005, pp. 327-35.
Martinez BD, Wiegand CS, Evans P, et al. Computer-assisted instrumentation during endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe alternate approach. Vascular. 2005;13(6):327-35.
Martinez, B. D., Wiegand, C. S., Evans, P., Gerhardinger, A., & Mendez, J. (2005). Computer-assisted instrumentation during endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe alternate approach. Vascular, 13(6), pp. 327-35.
Martinez BD, et al. Computer-assisted Instrumentation During Endoscopic Transaxillary First Rib Resection for Thoracic Outlet Syndrome: a Safe Alternate Approach. Vascular. 2005;13(6):327-35. PubMed PMID: 16390650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Computer-assisted instrumentation during endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe alternate approach. AU - Martinez,Bernardo D, AU - Wiegand,Catherine S, AU - Evans,Patricia, AU - Gerhardinger,Angie, AU - Mendez,Jose, PY - 2006/1/5/pubmed PY - 2006/4/13/medline PY - 2006/1/5/entrez SP - 327 EP - 35 JF - Vascular JO - Vascular VL - 13 IS - 6 N2 - UNLABELLED: The purpose of this article is to discuss the feasibility of using computer-enhanced instrumentation to improve visualization and therefore patient safety during transaxillary first rib resection. From November 1998 to July 2005, 105 patients who had failed conservative treatment underwent 131 procedures for thoracic outlet decompression. Eighty-nine endoscopic transaxillary first rib resections were completed using Aesop/Hermes integrated voice control instrumentation (Computer Motion, Goleta, CA). Since February 2003, dissection in 42 procedures was performed using the daVinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA). The surgical findings with cervical bands correlated with the preoperative symptoms. One hundred percent of patients with a combination of neurogenic and arterial thoracic outlet syndrome (TOS) requiring cervical rib resection had Roos type I and/or II bands. Additional surgical findings included the following: combination of neurogenic and arterial TOS without cervical ribs or neurogenic TOS alone had type III, IV, or V bands, and patients with venous compression (100%) had type VII bands. No mortalities or permanent neurovascular injuries occurred. There was a 6.1% postoperative complication rate. Persistent myofibrositis was found in 34% of patients with ongoing symptoms. CONCLUSION: The daVinci three-dimensional optical imaging system enhances visualization, thereby promoting telemanipulation of soft tissue structures in a relatively inaccessible working space. Endoscopic computerized instrumentation in transaxillary first rib resection decreases the risk of neurovascular injury, promotes complete decompression, and therefore provides a safe alternative to standard first rib resections. SN - 1708-5381 UR - https://www.unboundmedicine.com/medline/citation/16390650/Computer-assisted_instrumentation_during_endoscopic_transaxillary_first_rib_resection_for_thoracic_outlet_syndrome:_a_safe_alternate_approach L2 - http://journals.sagepub.com/doi/full/10.1258/rsmvasc.13.6.327?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -