Shoulder Surgery - Shoulder Arthroscopy

After an anesthetic has been administered, your surgeon and the operating room staff will then make sure that you are correctly position on the operating table. For some shoulder surgeries you will be placed in the "beach chair" position, as if you are reclining on a beach chair. Other types of shoulder surgery require that you lie on your side and have your arm in traction. This position is becoming more popular and is now quite common for arthroscopic rotator cuff repairs.

In this series of pictures, a patient with a torn rotator cuff is positioned on the operating table, the left arm is isolated from the rest of the body with surgical drapes, and then cleaned with a special surgical soap. This shoulder arthroscopy procedure is being performed under a general anesthetic and in the "beach chair" position.

Once you are in the correct position on the operating table your arm will be cleaned with special surgical soaps and the draped off from the rest of your body with sterile surgical drapes. Some of the surgical soaps that are used today create a film that adheres to the skin very well and does not wash off easily. It can often take days for this type of soap to wash off completely, but don't worry, it does not stain the skin permanently. After the shoulder has been "prepped and draped", the surgeon is then ready to begin the procedure.

After the arm has been properly cleaned and draped, the anatomic landmarks are drawn on the skin with a marker, and small incisions are created in order to insert the arthroscope and arthroscopic instruments.

Shoulder arthroscopy is performed through "portals". These are small incisions, generally about ½ of an inch to an inch long in the skin, are located over particular areas of the joint that the orthopedic surgeon will need to operate upon. Small plastic tubes, called "cannulas" are then inserted into the portals so that instruments can easily be placed in the shoulder joint. Shoulder arthroscopy itself involves inserting a specially designed video camera with a very bright fiber optic light source into the shoulder joint so that the important parts of the joint can be seen. Instruments that have been specially designed to remove inflamed tissue, attach sutures to bone, and repair tears and damaged tendons are then used to operate inside the shoulder.

Once the arthroscope is inserted into the shoulder joint, the surgeons are able to view the shoulder arthroscopy procedure on a television that shows an image of what is happening inside the shoulder joint.

Once the procedure is finished, the instruments, camera, and cannulas are removed, the wounds are closed with either suture or staples, and a sterile dressing is applied to the shoulder. The shoulder is then placed in a sling or immobilizer, the patient is moved from the operating table to a hospital bed, and then wheeled back to the recovery room. Depending upon what is involved with the shoulder surgery, the patient is either admitted to the hospital, or allowed to go home on the same day.

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