Thoracic outlet syndrome (TOS) causes arm pain, numbness, weakness and vascular symptoms from compression of nerves and blood vessels in the narrow space between the collarbone and first rib. Robotic keyhole technique for TOS decompression — all patients treated to date have experienced significant relief of symptoms. Conservative treatment is always considered first. Shoulder, arm & hand pain page →
Last reviewed: April 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382
Arm pain, tingling, numbness or weakness — often worse with overhead activity. May cause arm swelling if blood vessels are compressed
Cervical spine disease, rotator cuff injury, carpal tunnel syndrome, or peripheral neuropathy — before the correct diagnosis is made
Conservative treatment first. Robotic keyhole first rib resection where surgery is indicated. All patients treated to date have experienced significant symptom relief
Thoracic outlet syndrome (TOS) is a group of conditions caused by compression of the nerves and/or blood vessels as they pass through the thoracic outlet — the narrow space between the collarbone and the first rib. Compression can involve the brachial plexus (neurogenic TOS), the subclavian artery (arterial TOS), or the subclavian vein (venous TOS).
Neurogenic TOS — affecting the nerves — is the most common form and typically causes pain, numbness, tingling, and weakness in the arm, hand, and neck. Symptoms are often worsened by overhead activities, carrying heavy loads, or sustained arm use.
Vascular TOS can cause arm swelling, discolouration, or coldness. Arterial TOS, the least common form, can in severe cases cause limb-threatening ischaemia and requires urgent assessment.
Dr Okiror performs robotic keyhole first rib resection for thoracic outlet syndrome at London Bridge Hospital. Initial results have been excellent — all patients treated to date have experienced significant relief of their symptoms, with faster recovery compared to conventional open approaches. Conservative treatment is always considered first and all patients undergo a full multidisciplinary assessment before any surgical recommendation is made.
TOS surgery is highly specialist and performed at only a small number of centres in the UK. It requires expertise in thoracic surgery. Dr Okiror offers robotic keyhole decompression at London Bridge Hospital, with excellent outcomes in all patients treated to date.
Appointments within 2–3 days. Self-referrals welcome.
Jo Mitchelson, Private PA · 020 7952 2882 · pa@lungsurgeon.co.uk
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