Dry Arthroscopy of the Shoulder: A Technical Tip for the Beginner to Shoulder Arthroscopy

Backround: Most of the shoulder pathologies can be treated by shoulder arthroscopy. The major problem for the surgeon who has just started the shoulder arthroscopy is the difficulty of finding the joint in the first attempt. This resul ts with uncontrolled fluid leak age to the surrounding soft tissues. Especially in obese patients this condition prolonges the operation duration. To prevent this, the following procedure is recommended. Methods: The technique can be summarized as follows: i. after entering from the pos terior portal; the arthroscope is placed on to the three way canula, however the joint is not filled with fluid. ii. An injector is used to inject air from the canula. iii. Pumping the air makes the joint more visible and after dry dioagnostic arthroscopy the fluid can be pumped. Results: This technique enables the surgeon to fill the joint after being sure that the canula is in the joint to prevent unconrolled fluid extravasation. By this procedure the natural view of the joint can also be seen. A diagnos tic arthroscopy can easily been done. Discussion and conclusion: We recommend this technique in the first 10 shoulder arthroscopy of the new starter surgeon. It is suggested to apply classical procedures after gaining considerable experience. But the tech nique can be used for dry diagnostic shoulder arthroscopy also by an experienced surgeon. Level of Evidence: Level V