Hello I am posting to see if anyone has any info. on the different approaches for Venous TOS surgery. I have been diagnosed with Venous TOS and have been recommended to undergo rib resection and scalenectomy. I have received a few opinions from vascular surgeons, some recommending a transaxiallary (under arm pit) approach and others Infraclavicular ( under collarbone) approach. If anyone has info. regarding these approaches as far as which one has the best results as well as better recovery I would appreciate it.

You can try a forum some of those search terms to find past posts on venous or various surgical techniques..

Vascular TOS surgeries generally have better outcomes, but as always seek out the best /skilled surgeon that you can find..
I think some surgeons have their own preferences for techniques or it may depend on the patient/and where the actual issue is.

Have you had clots from it, or lots of swelling and heaviness?

Robotic Thoracoscopic First Rib Resection for Paget-Schroetter Disease is an option you did not list.

Recovery is faster than what I read from other's experiences.

I have had a clot that was treated with thrombolysis as well as swelling and heaviness which have both mostly subsided since treatment

I'm sorry I don't know more about the statistics, but I had the infraclavicular approach done for my rib resection, scalenectomy, and aneurysm repair for arterial TOS. My surgeon was Dr. Thompson at Wash U. I had a very good outcome and was pleased with the entire process.

JR1977 thank you for the response, Do you mind telling me a little about your experience with the surgery and post op recovery time. How many nights in the hospital? And how long before the pain subsided and return to activities. I have seen posts about post op experiences with numbness in the chest area.

Sure. My surgery was 6-8 hours long (it's been almost 2 years, so I can't remember exactly). I was in the hospital for 4 nights. I slept a lot of that time. My pain was well-controlled with a morphine button, oral meds, and a "pain ball" near the location of the incision.

My parents stayed at the Parkway Hotel which is attached to Barnes Jewish Hospital, and then I stayed there for 2 nights after I was discharged from the hospital so that I would be there for a PT consult and a post-op appointment where I got my drain removed.

The pain was pretty bad early on, and I had to be sure to stay on top of it with the pain meds. I had plenty of meds, so it just kind of ended up being a concern about how sedated I wanted to be. After a few weeks, I really wanted to be able to be up and around more, so I started weaning off the meds. I went back to work half-time at 4 1/2 weeks, and by that time I was only taking hydrocodone at night (I was done with the OxyContin). I went back to work full-time at 5 1/2 weeks. I was still pretty tired and in some pain especially when I had to type a lot but generally did pretty well.

I was in PT for almost 9 months after my surgery. Overall I think my outcome was good. I still get some muscular pain off and on, but it's not nearly as bad as it was before my surgery. And now I don't have to worry about my aneurysm causing any problems. I do have some numbness right around the surgery site, but I don't notice it very much.

Please let me know if you have any other questions!