What exactly is arthroscopic shoulder surgery?
Arthroscopic shoulder surgery is a surgical technique that is included within the so-called minimally invasive techniques, because through small incisions (less than 1 centimeter) access to the shoulder joint and can see, diagnose and treat various pathologies, without having to make large incisions.
Arthroscopy is the technique of choice for the diagnosis and treatment of shoulder injuries.
How is this procedure performed?
Shoulder arthroscopy surgery is usually performed under general anesthesia. Prior to general anesthesia, a brachial plexus nerve block will be applied at the neck level to numb the nerves leading to the arm. This is an ultrasound-guided puncture to locate the nerves that go to the arm and thus anesthetize them to avoid pain. In this way the postoperative period will be more comfortable and with less pain than conventional shoulder surgery.
Through small incisions (2, 3 or 4, depending on the pathology to be treated) a lens and very small instruments (approximately the size of the tip of a pen) are introduced, which are connected to a lighting system that allows illumination and magnification of the shoulder structures, which are projected onto a screen where they can be observed by the orthopedic surgeon.
After the surgery is completed, the patient is placed in a sling which, depending on the type of pathology, will be maintained for a longer or shorter period of time.
The surgery itself lasts between 30 and 90 minutes, depending on the patient’s injuries and the pathology to be treated.
Usually, the patient goes home the same night. In some cases, if the pain is not controlled, the patient stays in the hospital that day and leaves the following day.
What problems can be treated?
Shoulder arthroscopy can treat shoulder problems that appear in patients with shoulder pain or limited movement and that have not improved with medical and physiotherapeutic treatment. Previously, this type of injury required much more complex surgery, with longer recovery periods.
Specifically, shoulder arthroscopy is used for different pathologies, such as rotator cuff tears, subacromial syndrome, shoulder instability, recurrent shoulder dislocation, labral lesions, biceps tendon pathology, etc.
What are the advantages of this technique over the others?
The main advantage over the conventional technique (open surgery) is that access to the shoulder joint through small incisions means less invasion of the joint, less complicated postoperative period with less pain and less immobilization time. And therefore a better and earlier recovery.
Another very important advantage is that we can access much more easily to areas of the shoulder that are difficult to access, having a complete view from the inside.
Logically, the esthetic issue is also important, since the wide scars of conventional surgery are avoided.
What are the risks of this surgery?
Although this surgical procedure is considered safe, like any surgery it is not free of possible complications, such as risk of infection, bleeding or injury to blood vessels or nerves, stiffness of the shoulder.
Despite these possible complications, it is important to say that the probability of complications is much lower than in conventional or open surgery. That is why it is the technique of choice for most shoulder surgeries.