Robotic First Rib Resection in Thoracic Outlet Syndrome: A Systematic Review of Current Literature.
Maikerly ReyesSneha AlaparthiJohannes B RoedlMarisa C MoretaNathaniel R EvansTyler GrendaOlugbenga T OkusanyaPublished in: Journal of clinical medicine (2023)
Thoracic outlet syndrome (TOS) involves the compression of neurovascular structures in the thoracic outlet. TOS subtypes, including neurogenic (nTOS), venous (vTOS), and arterial (aTOS) are characterized by distinct clinical presentations and diagnostic considerations. This review explores the incidence, diagnostic challenges, and management of TOS with a focus on the innovative approach of Robotic First Rib Resection (R-FRR). Traditional management of TOS includes conservative measures and surgical interventions, with various open surgical approaches carrying risks of complications. R-FRR, a minimally invasive technique, offers advantages such as improved exposure, reduced injury risk to neurovascular structures, and shorter hospital stays. A comprehensive literature review was conducted to assess the outcomes of R-FRR for TOS. Data from 12 selected studies involving 397 patients with nTOS, vTOS, and aTOS were reviewed. The results indicate that R-FRR is associated with favorable intraoperative outcomes including minimal blood loss and low conversion rates to traditional approaches. Postoperatively, patients experienced decreased pain, improved function, and low complication rates. These findings support R-FRR as a safe and effective option for medically refractory TOS.
Keyphrases
- minimally invasive
- spinal cord
- end stage renal disease
- case report
- robot assisted
- risk factors
- chronic kidney disease
- systematic review
- newly diagnosed
- ejection fraction
- healthcare
- chronic pain
- high resolution
- peritoneal dialysis
- spinal cord injury
- emergency department
- prognostic factors
- physical activity
- type diabetes
- electronic health record
- big data
- metabolic syndrome
- glycemic control
- patient reported outcomes
- deep learning
- adipose tissue
- artificial intelligence
- human health
- case control