Arthroscopic Bankart Repair: Accessory Posterior Portal With Slotted Cannula for Lowest Capsulolabral Access Oren Tsvieli, M.D., Ehud Atoun, M.D., Eyal.

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Presentation transcript:

Arthroscopic Bankart Repair: Accessory Posterior Portal With Slotted Cannula for Lowest Capsulolabral Access Oren Tsvieli, M.D., Ehud Atoun, M.D., Eyal Amar, M.D., B.Sc., Ofer Levy, M.D., M.Ch.(Orth), F.R.C.S., Ehud Rath, M.D. Arthroscopy Techniques Volume 3, Issue 3, Pages e403-e408 (June 2014) DOI: 10.1016/j.eats.2014.02.010 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 Surgical technique for safely applying the API portal during arthroscopic Bankart repair, allowing one to reach the most inferior capsulolabral junction and the axillary pouch. (A) Surface anatomy (right shoulder, lateral decubitus patient positioning with lateral traction) showing location of API portal. One should note the anatomic location below the tip of the acromion 2 to 3 cm inferior to the posterior viewing portal. (B) Probing with an 18-gauge spinal needle (right shoulder, arthroscopic view from posterior viewing portal). One should note the optimal reach and trajectory of the needle toward the axillary pouch and the inferior capsulolabral junction, as well as the anteroinferior labrum. (A, C) The slotted cannula is slid over the spinal needle; sliding it tightly adjacent to the needle ascertains a safe track into the joint. (D) Tool exchange with spinal needle over slotted cannula. (E) Access and manipulation of lowest capsulolabral tissue. (F) Suture passage and collection while maintaining traction of tissue from posteroinferior portal. Arthroscopy Techniques 2014 3, e403-e408DOI: (10.1016/j.eats.2014.02.010) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 Slotted cannula from FAST-FIX Meniscal Repair System for safe tool exchange using API portal. Arthroscopy Techniques 2014 3, e403-e408DOI: (10.1016/j.eats.2014.02.010) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 (A) Arthroscopic access to HAGL lesion using API portal. The HAGL lesion is identified. The muscle striation of the subscapularis should be noted. (B) Humeral anchor placement using API portal and slotted cannula. (C) Reduction of HAGL lesion by suture anchor. Arthroscopy Techniques 2014 3, e403-e408DOI: (10.1016/j.eats.2014.02.010) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions