Shoulderdoc - Patient information and professional educational material on shoulder and elbow problems
For Treatment or More Information:
info@shoulderdoc.co.uk
01625 545071/2/3
Back Home Up Search

4 - Clinical procedure

Shoulderdoc
Medical Education
Shoulder Books
Shoulder Arthroscopy - Bunker and Wallace
4 - Clinical procedure
Clinical procedureClinical procedure
Arthroscopic photographyArthroscopic photography
Bursal endoscopyBursal endoscopy
CannulationCannulation
Draping the patientDraping the patient
EquipmentEquipment
Introducing the needleIntroducing the needle
PositioningPositioning
Preoperative proceduresPreoperative procedures
Shoulder holdersShoulder holders



Google Shoulderdoc
[ Advanced Search ]

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.

ShoulderDoc.co.uk satisfies the INTUTE criteria for quality and has been awarded 'editor's choice'.



   >>Website last updated: 10 November 2014


Sitemap Sitemap   Print page Print   advanced searchSearch   email articleEmail

Clinical procedure

Theatre organization

arthroscopic surgery of the shoulder is a highly technical and demanding form of surgery. It requires special instrumentation and a highly skilled team consisting of surgeon, anaesthet­ist, scrub nurse and circulating nurse. Diagnos­tic arthroscopy of the shoulder, on the other hand, requires little more than an arthroscope, light source and hook probe, as well as a large helping of enthusiasm and determination on the part of the surgeon, and tolerance from the anaesthetist and the nursing team. Initially even diagnostic arthroscopy takes time, and the goodwill of the operating team is increased if they can all follow events on a television monitor.

Since shoulder arthroscopy is a very special­ized form of surgery, it is best performed in a dedicated day-case arthroscopy suite. Failing this, a good-sized general or orthopaedic theatre, with nurses trained in arthroscopic techniques of the knee, is the next best situation. To perform this type of surgery in a general surgical theatre with untrained staff needs an extremely optimistic outlook from the surgeon!

The surgeon should have a good training in arthroscopic surgery of the knee before under­taking arthroscopy of the shoulder, and this must be combined with an extensive know ledge of shoulder anatomy, pathology, and an ability to undertake open surgery of the shoul­der in an experienced and competent fashion. The surgeon should then attend a shoulder arthroscopy course, and practise on shoulder models before attempting any form of arthro­scopic procedure on the shoulder of a patient. The surgeon may wish to practise on cadaver shoulders but, unless very fresh cadavers are used, the shoulder soon shrinks and becomes difficult to move, and the whole process becomes rather sordid. It is far better to practise on models and to gain experience by assisting a surgeon who is competent in this technique.

A good theatre layout is shown in Figure 4.1 and is based on the dedicated suite of Dr L Johnson's unit, at Ingham Medical Center, Lansing, Michigan. The patient lies in the lateral decubitus position with the surgeon directly behind his/her shoulder. A Mayo stand with the principal arthroscopic equipment required for the procedure is placed directly opposite the surgeon, and the scrub nurse stands alongside the Mayo stand ready to hand instruments to the surgeon when needed. Directly beyond the instruments is the television stand on which are placed the television monitor, camera equip­ment, light source, shaver system and video recorder. The arm of the patient is supported by a shoulder holder. An extra Mayo stand with accessory instruments is placed to the right of the surgeon and the first assistant stands to the surgeon's left.

Figure 4.1 Suggested theatre setup for shoulder arthroscopy. An, Anaesthetist; N, Nurse; S, Surgeon; A, Assistant; M and M2, Mayo stands; TV, Television monitor; CSV, Camera, Shaver, Video.

at the side or outer aspect
'key-hole' surgery. Surgery performed via small incisions, using special instruments and a viewing scope..


Print page Print page    email article Email article

Bookmark this page:

  • del.icio.us
  • digg.com
  • furl.net
  • google
  • ma.gnolia.com
  • netvouz.com
  • newsvine.com
  • netscape
  • reddit.com
  • simpy.com
  • spurl.net
  • stumbleupon
  • technorati.com
  • yahoo


Tags: No tags defined for this article. [View tag cloud]

Related Articles

Bursal endoscopy
After the glenohumeral endoscopy has been performed, it is essential to pass on to the bu...
17/05/2006
Read more...

Positioning
The usual position for shoulder arthroscopy is the lateral decubitus position. A pillow i...
17/05/2006
Read more...

Preoperative procedures
Anaesthesia Local anaesthesia may be used for shoulder arthroscopy and Warren et al[...
17/05/2006
Read more...

Shoulder holders
A shoulder holder is a suspension device for the arm, used to distract the glenohumeral j...
17/05/2006
Read more...

Arthroscopic photography
Good documentation of shoulder arthroscopy still requires 35 mm photography, although com...
10/05/2006
Read more...

Equipment
For diagnostic shoulder arthroscopy A standard 30 degree knee arthroscope is used ...
10/05/2006
Read more...

Creative Commons Licence The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients. Full Disclaimer
Manchester Arm Clinic Shoulder fellowships Shoulder Scan Wrightington Upper Limb Unit
  Shoulderdoc.co.uk Website by Blackbox E-Marketing