Being Properly Installed

(1)

Générale de Santé Hopital privé de, l’Estuaire, Le Havre, France

2.1 Installing the Patient

To work inside the subacromial space, we are sometimes bothered by the table which prevents the scope being medialized.

The easiest in this case for a cuff is to change the surgical approach for a lateral approach. We shall see this in the cuff chapter. As in any surgery, the installation is essential (Fig. 2.1).

Fig. 2.1

Fig. 2.2

Care must be taken to have an unobstructed shoulder. This is always the case in lateral recumbency (Figs. 2.1 and 2.3).

Fig. 2.3

Fig. 2.4

Fig. 2.5

Incidentally, it is very important to check the pressure points oneself. We must anticipate the risks of lesion. This installation is checked before surgery, but it must also be checked during surgery either by the circulating nurse or by the anesthetist. The endotracheal tube is preferably placed at the opposite side of the operated shoulder (Figs. 2.4 and 2.5).

Be careful during surgeries; we tend to “pull” to decoapt and the cervical spine of the patient can be very overworked.