The 7 o’clock portal, also known as posteroinferior portal, is created to retrieve loose body and for the fixation of the posteroinferior labrum [6]. In order to create the portal in the outside-in manner, a skin incision is made 2–3 cm inferior to the standard posterior portal with the portal positioned just above the posteroinferior corner of the glenoid and labrum. For the inside-out creation of the portal, the switching stick should be inserted through the anterior portal positioned at 7 o’clock and then pushed through the capsule. The structures at risk are the suprascapular nerve and artery, the axillary nerve, and the posterior circumflex humeral artery.

The axillary pouch portal provides linear access to the entire inferior glenohumeral recess (IGHR) for arthroscopic instrumentation and visualization [2]. In order to make the axillary pouch portal, a spinal needle is introduced from a point 2–3 cm directly inferior to the lower border of the posterolateral acromion angle, approximately 2 cm lateral to the posterior viewing portal, angled approximately 30° medially in the axial plane. There are several advantages of the portal over the 7 o’clock portal and accessory posterior portals. The risk of damaging posterior neurovascular structures is lower than other portal positions due to its higher and lateral placement. Entrance above the posterior band of the inferior glenohumeral ligament prevents direct damage to its innervation or ligamentous fibers. Also, its lateral placement allows improved access to the IGHR and prevents overcrowding with medially placed posterior portal.

The location of the portal varies with the location of the pathology for providing a suitable angle for the placement of the anchors in the posterosuperior glenoid. The port of Wilmington, described by Morgan et al. [13], is the most notable trans-rotator cuff portal introduced for SLAP repair. The portal is established 1 cm anterior and lateral to the posterolateral corner of the acromion. It allows approachment of the suture anchor in the angle of 45° to the posterosuperior glenoid surface. Even though the anteroposterior location may vary according to the surgeon’s preference, it is recommended to be medial to the musculotendinous junction as lateral placement may injure the axillary nerve.

In case of a retracted tear of the posterior cuff involving the infraspinatus or teres minor, the accessory posteromedial portal is especially useful [8]. It enables an ideal position for suture passage by tendon-penetrating devices instead of using curved or angled suture relay devices, thus simplifying and accelerating the repair of the posterior portion of the rotator cuff tear. The entrance of the portal is made approximately 4–5 cm medial to the posterolateral corner of the acromion and 2 cm inferior to the scapular spine. Extended bursectomy of the medial and posterior subacromial space is recommended for the visualization of the entry point. However, too far medial bursectomy can injure the suprascapular artery.

First introduced by Lafosse et al. [10], this specialized portal is established to cut the superior transverse ligament for the decompression of the suprascapular nerve. The entry of the portal is between the clavicle and the scapular spine, approximately 7 cm medial to the lateral border of the acromion. This is about 2 cm away from the Neviaser portal medially. Under the direct visualization through arthroscope (outside-in manner), a spinal needle is inserted through the trapezius muscle just above the medial aspect of the coracoclavicular ligament aiming toward the anterior border of the supraspinatus muscle. A blunt trocar is recommended to dissect the fatty tissues around the suprascapular nerve and artery and to further clarify the border of the transverse scapular ligament.