In the first phase (Robotics 1.0), Robotic Surgical Technology brought enhanced dexterity and visualization to established minimally invasive procedures such as prostatectomy. In the second phase (Robotics 2.0), the technology has opened new vistas to the better understanding of pathologic processes in situ. Thoracic Outlet Syndrome (TOS) is an excellent example of an instance where greater visualization of the anatomy of a complex region of the body has resulted in a more enlightened understanding of disease. For decades, TOS has been divided into arterial, venous, and neurogenic varieties. Historically the only consistent aspects of TOS have been the confusion among medical practitioners, difficulty in making the diagnosis, and the poor results with surgical intervention. The present understanding of TOS is that it is the manifestation of a congenital malformation of the first rib. The congenital malformation is in the form of a pronounced tubercle which results in an abnormal costosternal joint and the compression of the subclavian vein (SV) at its junction with the innominate vein. The congenital disease is bilateral with variable symptomatic expression. The compression of the SV in the thoracic outlet results in a spectrum of disease which ranges from neurologic symptoms resulting from venous congestion and ischemia of the upper extremity nerves (Peet’s neurogenic TOS) to thrombosis of the SV with prolonged compression (Paget-Schroetter or Peet’s venous TOS). Robotic technology allows for the precise removal of the “offending portion” of the first rib. This technique is associated with the best reported results in patients with TOS.