Thank you for all the replies!

Sea Pines: I think you are correct regarding the transaxillary approach. I appreciate your thoughtful and informative response.

I just recently read this:
The advantage of this approach is that it gives the surgeon easy access to the first rib, artery and vein and lower brachial plexus without disturbing the rest of the brachial plexus. It also means the surgeon has limited access to the areas of the upper nerves and muscles.

It sounds like the transax approach was the right way to go in your situation.

Regarding neurolysis, I think I misunderstood the term initially. It appears "neurolysis" is used loosely to refer to both external neurolysis and internal neurolysis. Seems internal neurolysis is rarely done/needed, although I *wonder* if this step is especially important for NTOS outcomes. Perhaps I'll start another thread to gather opinions on this...

thanks again -