Robot-Assisted Endoscopic Neurolysis of the Thoracic Segment of the Long Thoracic Nerve

Abstract

The surgical management of the scapula alata is controversial. The most common surgical procedure performed is the neurolysis of the thoracic segment of the long thoracic nerve through a large skin incision of several centimeters. We hereby report the feasibility and the outcomes of an endoscopic robot-assisted neurolysis in a 25-year-old patient. This patient had sustained a thoracic trauma 8 months earlier which had resulted in a scapula alata. A minimally invasive neurolysis of the long thoracic nerve was performed through the da Vinci robot. The “crowfoot landmark” was managed through electrocoagulation and the entire thoracic segment of the nerve was released. Eighteen months after the procedure, the patient had fully recovered. The feasibility of the robot-assisted neurolysis of the long thoracic nerve was demonstrated by the uneventfulness of the procedure. With regard to the outcomes, the common disadvantages of an open neurolysis were absent: a cosmetic minimal surgical access was performed, the usual postoperative complications were not noted, and the typical perineural scarring that could lead to recurrence was ideally reduced.