Quote:
Originally Posted by Limoges
You can't completely remove the median scalene muscle because the long thoracic nerve runs through it.
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I'm sorry
Limoges but I think you are mistaken. To my knowledge and from what I have found on the Internet, the scalene muscle can indeed be completely removed. The operation involves locating and securing the relevant blood vessels and nerves before resecting the ligaments and the scalene muscle. The surgeon simply locates the nerves in the operation field and holds them out of the way throughout the procedure.
As you would know, many surgeons advocate removal of the first rib combined with removal of the scalene muscle, although some apparently advocate removal of the muscle alone.
" We completely detach the anterior scalene muscle from the first rib as well as from the subclavian vein, artery, and attachments to the fascia beneath the subclavian artery, vein and brachial plexus...."
http://www.vascularinstitute.com/page19.htm
Even Wikipedia has a piece about it:
"Surgical approaches have also been used successfully in TOS. In cases where the first rib is compressing a vein, artery, or the nerve bundle, the first rib and scalene muscles and any compressive fibrous tissue can be removed..."
References:
http://www.vascularinstitute.com/page19.htm
http://en.wikipedia.org/wiki/Thoracic_outlet_syndrome
http://ats.ctsnetjournals.org/cgi/co...full/75/4/1091
http://www.momentummedia.com/article...backobrien.htm
http://www.sharecare.com/question/remove-rib-surgery
http://www.surgery.ucla.edu/vascular...Syndrome.shtml
The following book describes the surgical procedure in full anatomical detail.
The Ischemic Extremity: New Findings and Treatment
By Heron E. Rodriguez, William H. Pearce, James S. T. Yao
http://books.google.com.au/books?id=...emoved&f=false
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