Shoulder arthroscopy is one of the most popular orthopaedic interventions and is an effective and relatively safe method of diagnosing and treating problems in the shoulder joint. Due to the minimally invasive nature of the procedure, patients can expect a faster recovery compared to traditional open surgery. Due to the popularity of the method, it continues to develop each year, both in terms of the equipment used and the methods employed during the procedure.
Shoulder arthroscopy in the beach chair position
A good operating table is valuable in its own right, but it must be complemented by the right accessories, as these are the ones most often used by staff during surgery. Reliability, adjustment ranges or speed of operation affect the perception of the entire set-up needed for the surgery. The so-called “beach chair” positioning is the most commonly observed way to access the shoulder complex. Advantages of this position include, for example, anatomical positioning of the patient in an upright position (minimising disorientation and facilitating the transition to open surgery)[1]. In this position, the range of movement of the shoulder joint is also large enough that it is very easy to carry out a pre-operative assessment of the joint and to gain better access already during surgery.
Disadvantages of the beach chair position
Surgeons also point out the negative aspects of this access. The most common are the difficult positioning of the patient, the need to juggle the headrests, or the insufficient working space behind the scapula. Researchers have also noted these problems, writing about difficulties in inserting the endoscope into the upper and posterior portals [2]. They also uphold the consensus that this is a position generally disliked by anaesthetists. This is due to the difficulty in maintaining airway patency and properly supporting the head.
Modern solutions for shoulder arthroscopy
Some medical equipment manufacturers are addressing the problems described above and trying to make the doctors’ work easier. The results of their efforts are not only good operating tables, but also accessories. One example is the latest Famed ARTHEROTM shoulder arthroscopy patient positioning system. An operating tabletop created, among others, in cooperation with dr Roman Brzóska of St Luke’s Hospital in Bielsko-Biała, a prominent specialist in this field and a member of the board of the Shoulder Section of the European Society of Sports Orthopaedics, Knee Surgery and Arthroscopy. This accessory solves all the above-mentioned problems and makes it possible to work comfortably in the “beach chair” position.
Shoulder surgery at St Luke’s Hospital in Bielsko-Biała using the Famed ArtHero shoulder attachment.
Making things easier for medical staff
Nowadays, modern accessories of this type can be adjusted using a remote control, making it very easy to position the patient on the table. Due to staff shortages in operating theatres, the attachment needs to be lightweight and mountable by one person. This makes it easily portable and reduces the spinal column load for the medical staff.
Shoulder arthroscopy and head positioning
There have been many head positioning solutions on the market for years, but not all are suitable for use in the beach chair position. The head of a patient placed in this position often changes its location during the adjustment of the individual tabletop sections. Therefore, it is necessary to ensure its full security. So-called stabilising helmets come to the rescue. However, many popular designs are problematic to put on, do not take into account the needs of the anaesthetist or expose the patient to the risk of facial paralysis [3].
Famed PRIME operating table with Famed ArtHero shoulder arthroscopy attachment.
Summary
In summary – the system streamlines the work, speeding up preparation for surgery and patient positioning, regardless of individual habits. The whole structure can be adjusted using a remote control or a gas spring assist. One of the advantages of the accessory is that it can be mounted by one person, thanks to its low weight and functional solutions. The tabletop can be fitted with accessories to support the patient’s head, such as a unique helmet designed for the work of surgeons and anaesthetists. The new arthroscopy accessory reduces patient preparation time and offers more space for the arthroscope, taking into account the multitude of surgical methods.
