When I went looking for info on a surgey for pec minor compression in August 2004, there was NOTHING to be found on the net - cause they weren't being done, not for nerve problems or chronic pain due to nerve problems anyway.
That October Sistah Anne and I were the first to offer up our pec minor tendons in the hope of pain relief, and since then it seems the good Drs have "discovered" a lot of us TOSers have this problem - uh, what took you so long, Docs?? I really find this SO curious!!

Anyway, there is beginning to be some info out there, and since it often goes with TOS, it makes sense to gather info and sites relating to pec minor syndrome and tenotomy as well. Please post any you find to this thread for the ease of those seeking to learn more about this subject.

This first bit is from Dr Sanders website; I'm really encouraged by the # of people whose pain improved enough from the fairly easy pec minor surgery that they elected not to have the rib resection. I don't think that wd have worked out in my situation, but it wd have been nice to have the option of going with the easy option first to find out! Here's Dr Sanders:

In 2005 we became acquainted with a condition that was described 60 years ago but which most of us had ignored, the pectoralis minor syndrome (described above under "cause" and "diagnosis"). Each patient we now see for TOS is also examined for this. We have been surprised to find that at least half the people who have TOS also have complaints and positive physical exam findings of pectoralis minor syndrome. If following a pectoralis minor block there is significant improvement within a few minutes, we have been performing a very simple operation called pectoralis minor tenotomy. This operation is performed through a 3 inch incision in the arm pit. The pectoralis minor muscle is easily found and cut at its attachment to the shoulder blade (at the coracoid process). One inch of the muscle is then removed to prevent it's reattachment to the top of the nerves going to the arm. The incision is closed with buried stitches. The operation usually takes less than 30 minutes and can be performed as an outpatient and recently we have found that this procedure can be performed under local anesthesia, but with an anesthesiologist in attendance so that patients are asleep for a short time but are awake within a few minutes of the end of the operation. The procedure carries almost no risk of injury.

In 2005 and 2006, we performed 130 pectoralis minor tenotomies as the only operation. 60 of these were performed in patients who previously had been operated upon by scalenectomy or first rib resection. They had experienced partial improvement in their symptoms from their operation but continued to complain of pain in the chest and pain over the shoulder blade.

Separately, 70 pectoralis tenotomies have been performed on patients who had not been operated upon previously. They had been seen because it was thought they had TOS. On exam, most of them did indeed have TOS, but also had findings of pectoralis minor syndrome. When their symptoms and findings on physical exam were dramatically improved by a pectoralis minor block, they were offered the simple operation of pectoralis minor tenotomy with the understanding that if they did not experience good relief of their symptoms they could return for the bigger operation of scalenectomy or first rib resection. To date, 6 patients have returned and received scalenectomies. The other 64 have had enough improvement that consideration of additional surgery has not been necessary.

Results of Treatment

Most people with TOS will improve with stretching and physical therapy. In our experience with over 5000 people with TOS, less than 30% had surgery. The improvement rate with surgery varies with the cause of the TOS. Auto injuries have a success rate of about 80% while repetitive stress at work has a success rate of 65-70%. Pectoralis minor tenotomy has only been performed for the past two years. The success rate to date is over 80%.