Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study

The abundant vascular structures that surround the shoulder joint are complex and variable, complicating arthroscopy approaches. The aim of this study is to determine safe and risky areas around standard posterior and standard anterior portals, and accounting for the distribution of neurovascular st...

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Autores principales:	Espinosa-Uribe,Abraham G, Morales-Avalos,Rodolfo, Gutiérrez-de la O,Jorge, García-de León,Oscar R, Torres-García,Jessica K, Guzmán-Avilán,Katia, Vílchez-Cavazos,Félix, de la Garza-Castro,Oscar, Guzmán-López,Santos, Elizondo-Omaña,Rodrigo E
Lenguaje:	English
Publicado:	Sociedad Chilena de Anatomía 2015
Materias:	Anatomy Arthroscopy Portals Safe Areas Shoulder
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022015000400033
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spelling	oai:scielo:S0717-950220150004000332016-03-22Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical StudyEspinosa-Uribe,Abraham GMorales-Avalos,RodolfoGutiérrez-de la O,JorgeGarcía-de León,Oscar RTorres-García,Jessica KGuzmán-Avilán,KatiaVílchez-Cavazos,Félixde la Garza-Castro,OscarGuzmán-López,SantosElizondo-Omaña,Rodrigo E Anatomy Arthroscopy Portals Safe Areas Shoulder The abundant vascular structures that surround the shoulder joint are complex and variable, complicating arthroscopy approaches. The aim of this study is to determine safe and risky areas around standard posterior and standard anterior portals, and accounting for the distribution of neurovascular structures of small and medium diameters that can lead to intra-articular bleeding during surgery. The standard posterior portal, and standard anterior portal were placed as described in the literature, and punch dissection was performed 2.5 cm around the trocar in situ. The arrangement of each identified structure was photographically documented and digitalized for each anatomic plane; the distance to the trocar and the diameter of each structure were measured. Based on each digitalized anatomic plane, safe and risky tissue areas were determined, and a clock face coordinate system was used to represent these areas. The safe area around the standard posterior portal was located between 11 and 1 o´clock for the left shoulder and 11 and 2 o´clock for the right shoulder. For the standard anterior portal, the safe area was located between 2 and 3 o´clock for the left shoulder and between 9 and 12 o´clock for the right shoulder. However, we did document a risk of injuring the cephalic vein 5 times, the axillary artery 3 times and the deltoid branch of the thoracoacromial artery once. This study reports quantitatively the total number of small diameter structures present in the two shoulder arthroscopic portals evaluated. The safe areas proposed in this study must be evaluated to propose new access points for performing arthroscopic procedures on the shoulder.info:eu-repo/semantics/openAccessSociedad Chilena de AnatomíaInternational Journal of Morphology v.33 n.4 20152015-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022015000400033en10.4067/S0717-95022015000400033
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Anatomy Arthroscopy Portals Safe Areas Shoulder
spellingShingle	Anatomy Arthroscopy Portals Safe Areas Shoulder Espinosa-Uribe,Abraham G Morales-Avalos,Rodolfo Gutiérrez-de la O,Jorge García-de León,Oscar R Torres-García,Jessica K Guzmán-Avilán,Katia Vílchez-Cavazos,Félix de la Garza-Castro,Oscar Guzmán-López,Santos Elizondo-Omaña,Rodrigo E Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study
description	The abundant vascular structures that surround the shoulder joint are complex and variable, complicating arthroscopy approaches. The aim of this study is to determine safe and risky areas around standard posterior and standard anterior portals, and accounting for the distribution of neurovascular structures of small and medium diameters that can lead to intra-articular bleeding during surgery. The standard posterior portal, and standard anterior portal were placed as described in the literature, and punch dissection was performed 2.5 cm around the trocar in situ. The arrangement of each identified structure was photographically documented and digitalized for each anatomic plane; the distance to the trocar and the diameter of each structure were measured. Based on each digitalized anatomic plane, safe and risky tissue areas were determined, and a clock face coordinate system was used to represent these areas. The safe area around the standard posterior portal was located between 11 and 1 o´clock for the left shoulder and 11 and 2 o´clock for the right shoulder. For the standard anterior portal, the safe area was located between 2 and 3 o´clock for the left shoulder and between 9 and 12 o´clock for the right shoulder. However, we did document a risk of injuring the cephalic vein 5 times, the axillary artery 3 times and the deltoid branch of the thoracoacromial artery once. This study reports quantitatively the total number of small diameter structures present in the two shoulder arthroscopic portals evaluated. The safe areas proposed in this study must be evaluated to propose new access points for performing arthroscopic procedures on the shoulder.
author	Espinosa-Uribe,Abraham G Morales-Avalos,Rodolfo Gutiérrez-de la O,Jorge García-de León,Oscar R Torres-García,Jessica K Guzmán-Avilán,Katia Vílchez-Cavazos,Félix de la Garza-Castro,Oscar Guzmán-López,Santos Elizondo-Omaña,Rodrigo E
author_facet	Espinosa-Uribe,Abraham G Morales-Avalos,Rodolfo Gutiérrez-de la O,Jorge García-de León,Oscar R Torres-García,Jessica K Guzmán-Avilán,Katia Vílchez-Cavazos,Félix de la Garza-Castro,Oscar Guzmán-López,Santos Elizondo-Omaña,Rodrigo E
author_sort	Espinosa-Uribe,Abraham G
title	Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study
title_short	Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study
title_full	Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study
title_fullStr	Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study
title_full_unstemmed	Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study
title_sort	safe areas for the placement of standard shoulder arthroscopy portals: an anatomical study
publisher	Sociedad Chilena de Anatomía
publishDate	2015
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022015000400033
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Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study

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