Arthroscopy, Bursoscopy and Subacromial Decompression - Left Shoulder

Video Transcription

What follows is a DVD of a left shoulder Arthroscopy, Bursoscopy and Subacromial Decrompression. We are currently viewing the glenohumeral joints in the posterior portal. Long-headed biceps seen at approximately 4:00. A needle has been introduced through the anterior portal, and we’re watching now the face of the glenoid. This has got healthy articular cartage, with some minor fragments that lay materially at 7:00. We’re now looking at the articular surfaces of the humeral head, we’re looking now into the inferior recess of the glenohumeral joint. Subscapularis and its upper border is visible in front of us as are the glenhumeral ligaments.
0:57 We are now going to withdraw the canulla from the glenohumeral joint and insert it into the subacromial space. We are currently looking into the subacromial space with a rotated cuff beneath us and the undersurface of the acromian above us. Instruments will be introduced through the lateral portal to our left, to perform a standard subacromial decrompression. Intra-articular pressure at this point is usually 50mmHg. A needle is introduced first, to ensure correct positioning of the canulla. The gray trocar is now visible in the middle of the screen. This is withdrawn and instruments are now passed through a clear canulla.
2:44 The first instrument to be introduced is a 3.55mm gator resector which clears the soft tissues from the subacromial space. As you will see, visibility is excellent. Synovium and soft tissues are cleared from the space, ensuring good view of the operative field.
3:09 For the rest of the video, you will three various instruments being used. Firstly this 3.55mm gator resector, then you will see an arthrex wand, which is a soft tissue abrator, and then finally, a 6mm oval burr. All these three instruments work collectively to sculpt the undersurface of the acromian into a tight wand shape with a reverse bevel, and producing a slight flare to the lateral border of the acromian, ensuring a satisfactory decrompression of the subacromial space. The coracoacromail ligament is also divided.

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