Questions to ask surgeon about first rib resection
 

Can someone please help me compile a list of questions about the surgery. Thanks !

Ask him the following
1 how do you do the surgery through arm pit or above the collar bone
2 do you recostruct the vein
3 if the vein is not rebuilt then do I need to be on coumadin for ever.
4 do you ever stent the vein, if the answer is yes I would really question how good he is
Because that is not recommended.
5 what are chances for nerve injury during my operation.
6 is he going to open the subclavian veinbfirst before surgery
If he doesnt open the subclavian vein I would question his management as that is against
The recommendations by the experts in the field.
Good luck to you. I hope that helps. Dont be bashful ask him all the questions
You deserve to know as it is your health.

Thank you! Have you heard of Dean Donahue?

i firmly believe my role here is to provide you with the most education about VTOS so you can make the best decision about the right treatment for you.
Somethings that TOS patients need to know is that some of the highest volumed surgeons that treat tos are not located in major medical centers. something else about TOS is that not all surgeons agree on the same treatment. The field of tos treatment is flawed with the lack of clinical standards as there has never been a large randomized trials done for any of the types of tos surgery or treatment. for example think about breast cancer, it is usually a board certified surgical oncologist that performs the surgery and post op therapy is very well established any deviation from it leads to poor outcomes and malpractice. In TOS surgery, no such thing, I have seen neurosurgeon, vascular surgeon, thoracic surgeon, plastic surgeon all perform this type of surgery. as you can tell there is no standard and i am sure the outcome varies greatly. Now, in this day and age it is almost unacceptable. As tos surgeons we are currently trying to establish such standard in the field. My professional opinion is that this type of procedure is best performed by a vascular surgeon ( not because I am one). Because we are the group that is trying to establish a standard of care for tos patients. I think you are going to MGH. I know the surgeons there. the vascular surgeons there are actually the specialist in the treatment of effort thrombosis. I think dean is a thoracic surgeon. The vascular surgeons there perform around 20 cases of VTOS surgery a year (I know them very well). I cant imagine dean does more than that a year. He may do a lot of neurogenic tos surgery. but it is very important for you to know that effort thrombosis (although considered to be a type of tos ) is totally different from NTOS. a different compression in a different space that causes effort thrombosis. So if any thing I think you should consider visiting their vascular surgeons while there in MGH. Please ask me more questions as you wish. I really hate to see you mistreated.

thank you for your advice. you mentioned you were a vascular surgeon. I am seeing a vascular surgeon here at univeristy of miami, but he hasnt had much experience with first rib resections. he told me he has done over 10. A close friend was a fellow of Dr Donahue, whom I have spoken to personally and based on peoples comments in this forum, I trust him. I should hear from him today on his opinion. I am willing to travel for this surgery since I am aware of the complicatins and understand only a skilled surgeon with experience should be performing it.

dr dpnahue is cardiothoracic
 

He is a cardiothoracic surgeon. When I first saw a vascular surgeon he said he would need a thoracic surgeon to assist so two surgeons would be operating on me. Dr Donahue does the surgery by himself.

did he operate on you?

I had two rib resection surgeries this year by Dr. Donahue...I can't say enough great things about him!

@ladylaura : I just scheduled the surgery with DR.Donahue. Anything you can tell me would be awesome. Do you have venous tos?

Is this for VTOS or NTOS? Do you recommend the same questions for both?
Also for an NTOS cervical rib resection, does body size factor into how likely you are to continue to have symptoms after the surgery?