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. 2020 Oct 1;9(10):e1591-e1596.
doi: 10.1016/j.eats.2020.06.025. eCollection 2020 Oct.

The 2-Scope Technique for Rotator Cuff Surgery: Are 2 Scopes Better Than 1?

Stefano Gumina  1 , Marco Rionero  1 , Vittorio Candela  1
Affiliations

The 2-Scope Technique for Rotator Cuff Surgery: Are 2 Scopes Better Than 1?

Stefano Gumina et al. Arthrosc Tech. .

Abstract

The arthroscopic treatment of rotator cuff tear involves 2 distinct phases: intra-articular and subacromial. We present the 2-scope technique with the aim to simultaneously perform these phases, entrusting them to 2 experienced surgeons, and to obtain possible benefits compared with the classic 1-scope technique. Better nosology of the lesion and a more accurate evaluation of suture passer action (equidistance of the sutures and avoidance of degenerated articular-side tendon areas) represent benefits of this technique. In contrast, the 2-scope technique needs an additional lateral portal and could give rise to an erroneous distribution of costs and surgeons.

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Figures

Fig 1
Fig 1
Right shoulder with patient placed in beach-chair position.
Fig 2
Fig 2
A double instrumentation set is prepared for the 2-scope technique.
Fig 3
Fig 3
Two surgeons are simultaneously performing an arthroscopic rotator cuff repair with the 2-scope technique in a right shoulder. The first arthroscope (white arrow) is intra-articular through a posterior portal; the second arthroscope (black arrow) is in the subacromial space through a lateral portal.
Fig 4
Fig 4
Simultaneous view of shaver action (arrows) from subacromial space (A) and intra-articular joint (B) in right shoulder. Only the subacromial lighting is turned on.
Fig 5
Fig 5
View of large rotator cuff tear (arrows) in right shoulder from first intra-articular arthroscope. The second arthroscope is in the subacromial space; only the subacromial lighting is turned on.
Fig 6
Fig 6
Intra-articular view of large rotator cuff tear in right shoulder from lateral portal (second arthroscope) (A) and posterior portal (first arthroscope) (B). In both images, tendon quality is assessed while the rotator cuff is raised by a probe (asterisks).
Fig 7
Fig 7
Right shoulder. (A) Suture passer action: view from subacromial space through second arthroscope. The asterisk indicates the intra-articular lighting from the first arthroscope. (B) The accuracy of suture passer action and the quality of the articular-side tendon are assessed by the first arthroscope (posterior portal).
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References

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