Blood vessels and nerves pass through or close to the 1st rib on both sides of the body, which is an area called the "thoracic outlet." This area can be affected by injuries and chronic muscle changes from certain repetitive tasks, leading to disease that affects the nerves and blood vessels that go to the arms. This "thoracic outlet syndrome" can be debilitating but often is amenable to surgical "widening" of the area through removal of the entire 1st rib and any accessory ribs that may be present. Patients can experience dramatic relief of their symptoms but expert evaluation and surgical technique is required to avoid nerve and blood vessel injury. Dr. Cameron has had extensive experience operating in the area of the 1st rib for these types of problems as well as tumors causing similar problems and may be one of the worlds expert in doing these procedures with the use of the Da Vinci surgical robot.