Thank you for clarifying that!

My doctor favors the transaxillary approach (under the arm). I have not had surgery, so I can't comment on that.

Would like to hear any surgery stories for VTOS and the approach used.

I have bilateral venous TOS. I am one year post robotic rib resection which did nothing to help my symptoms. I have new issues that have crept up since surgery. TOS is a very individualized disease so surgical outcomes will vary. In regards to the robotic approach, the surgeon goes through the rib cage, deflates the lung, and then approaches the rib from the inside. They then remove the bony knuckle closest to the sternum leaving the rest of the rib and scalenes in tact. The surgical robot instruments and chest tube get close to the intercostal nerve which in my case left me with nerve damage. The surgeon only advised me of this possible side effect after I went through the procedure. The end result is pain, numbness, and shallow breathing with some days better than others. mix in some new emotional baggage to contend with. You should exhaust all other options before entertaining surgery regardless of the approach.

I had a supraclavicular first rib resection in May at MGH with Dr. Donahue for vTOS. (I had a DVT about a year before.) He's great.

I was off pain killers in less than a week. He wanted me to wait 3 months before resuming weight lifting. I felt ready much before that. But I took it easy to be safe.

I have absolutely no problems related to surgery. It's been about 7 months, but I was pretty much perfect at 4, just a little tightness near the scar back then. Some shirts still irritate it, but that's all.

One day last week I did 100 chin ups. No issues. None heavy squatting, deadlifting, or rowing. My subclavian seems to be improving. My hand gets a little dark, but the collaterals don't fill like they used to. And my left and right arms fatigue at the same time.

I'm very happy with the result.