Abstract
The Dual Approach for resection of the first rib was created because of the necessity to take advantage of the transaxillary route to reach the anterior portion of the rib while at the same time avoiding the multiple complications that can occur when trying to use that approach alone to reach the posterior end of the rib. It is, therefore, a combination of a transaxillary and a new posterior incision very different from the vertical incision proposed by Clagett and used by Urschel, and others. This new technique was first published in 1998 [1] and has been used for more than 25 years at the University of Minnesota for specific elective treatment of the neurogenic thoracic outlet syndrome when no vascular repair needs to be undertaken in the subclavian artery. It is our standard operation for the uncomplicated neurogenic-arterial thoracic outlet syndrome.
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Molina JE. Combined posterior and transaxillary approach for neurogenic thoracic outlet syndrome. J Am Coll Surg. 1998;187:39–45.
Urschel Jr HC, Razzuk MA. Ch 18. Thoracic outlet syndrome. In: Sabiston DC, Spencer F, editors. Surgery of the chest. 5th ed. Philadelphia: Saunders; 1990. p. 536–53.
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Molina, J.E. (2013). The New Dual Approach. In: New Techniques for Thoracic Outlet Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5471-7_10
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DOI: https://doi.org/10.1007/978-1-4614-5471-7_10
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