The surgical maneuver involves the release or removal of the confounding structures such as cervical rib excision, scalene muscle release, first rib resection and resection of fibro muscular bands.

A First rib resection is a surgical procedure used in humans to treat thoracic outlet syndrome. It is often accompanied by scalenectomy, or removal of the nearby anterior scalene muscle. It involves the surgical removal of a segment of the first rib, which is the rib closest to the head, under the collar bone