Additionally a role is placed in the axilla to enable the surgeon to have a clear and good view to the 6 o’clock position and an overview over the rest of glenoid, labrum, and capsule.

For a better orientation, the anatomical landmarks are marked, and a posterior standard portal is created first to insert the scope (Fig. 7.2).

Under visualization the anterosuperior and anteroinferior portals are generated using a spinal needle. This allows for accurate portal placement. After a diagnostic overview, the displaced labrum is visualized, and a probe is used to determine the size of the defect, followed by neck roughening to support healing with a rasp or burr (Figs. 7.3 and 7.4). To refix and reduce the capsule, a “suture fist” technique is used in which a PDS-0 is passed through the labrum and capsule at the 6 o’clock position. A suture anchor is then placed at the 7 o’clock position (left shoulder), and a high strained number 2 suture is then shuttled through the labrum and capsule by using the PDS (Fig. 7.5). If a double-loaded suture anchor is used, this can be repeated to even more the IGHL retention. If necessary a mattress stitch configuration can be performed (Fig. 7.6). Depending on the size of the Bankart lesion, two to three anchors are placed in the same technique for labral refixation (Fig. 7.7). It is very important to take normal variations of labral configurations, such as a Buford complex or a cord-like MGHL. Postoperative protocol is shown in Table 7.1.