Rotator Cuff Repair Using a Needle Arthroscope Through a Dual-Lumen Flexible Cannula

ABSTRACT: The advent of arthroscopy in shoulder surgery has allowed for the development of minimally invasive techniques for the treatment of shoulder pathology. Further developments in needle arthroscopy have continued this trend toward less invasive shoulder surgery, allowing for decreased pain using smaller portals and decreased fluid irrigation through the shoulder joint during surgery. This technique describes a minimally invasive rotator cuff repair using a dual-lumen cannula that provides both direct visualization and direct instrument access to the pathology. This new cannula has the potential to further refine and to simplify needle arthroscopic techniques about the shoulder. With judicious patient selection, needle arthroscopy is a viable option for the treatment of common shoulder pathology. Technique Video Video 1 A spinal needle is used to create a location for the standard lateral portal, and using a hemostat, the Passport Dual Lumen Cannula (Arthrex) is then inserted to be a working and viewing portal. A spinal needle is seen from superior, and lateral to the acromion, the placement for the medial 2 knotless anchors is located. A small stab incision is made and the punch is brought in, and while viewing from lateral, the medial anchors are placed. The medial swivel lock (Arthrex) anchors loaded with sutures are then placed in standard fashion. While viewing through the lateral portal with the NanoScope in the axillary lumen, a suture retriever is used to retrieve the suture tape coming out of the anterior-most anchor, and it is loaded into a Scorpion (Arthrex) suture passer. This passer is then used through the main lumen from the lateral portal to pass the anterior and posterior respective sutures through the rotator cuff. Those are then retrieved superiorly and cut to give 4 separate sutures. One anterior suture and 1 posterior suture are retrieved from lateral while still viewing with the NanoScope through the axillary lumen. These are placed through a knotless swivel lock, and the lateral row anchors are punched for from laterally in standard fashion. The anchors are then tensioned and placed into the bone while directly visualizing from the lateral portal. Final views of the repair and the shoulder are then seen.

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PROVIDER: S-EPMC9706136 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature