Case: A 25-year-old man presented with neck and upper-limb pain. He underwent surgery for the resection of a left hypoplastic first rib, which was causing thoracic outlet syndrome. The subclavian vein was retracted through an infraclavicular incision, and an endoscope was inserted dorsally to the vein. With the assistance of endoscopy, the first rib was partially resected, and scalene muscles were released from the rib. The preoperative symptoms improved after surgery without any complications.
Conclusion: The endoscopic-assisted infraclavicular approach enabled sufficient resection of the hypoplastic first rib, leading to satisfactory outcomes. This method can be considered as an option for resecting a hypoplastic first rib.
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