Anterior approach to brachial plexus

Anterior approach to brachial plexus

01. Thoracic outlet and brachial plexus approach
Right-sided transverse neck skin incision. The platysma m. was divided and superficial dissection was done exposing the external and internal jugular veins. The dissection is lateral to the sternocleidomastoid m.
02. Phrenic nerve and brachial plexus
The dissection was extended and the phrenic nerve is presented running just above the anterior scalene m. The brachial plexus trunks are visible between the anterior and middle scalene mm.
03. Anterior scalene m. transected
The anterior scalene m. was transected, exposing the middle and inferior trunks and long thoracic nerve better.