Shoulder Arthroscopy in Tunisia

A shoulder arthroscopy is a minimally invasive procedure conducted to inspect, diagnose, and rectify the problems involving the shoulder joint. During a shoulder arthroscopy, a small device attached to a camera is inserted into the shoulder to diagnose the reason for pain in the shoulder, among other problems.

Miniature surgical instruments are also inserted into the shoulder to rectify the identified problem. Such a surgery is known as arthroscopic shoulder surgery. When shoulder replacement is conducted with the help of arthroscopy, the procedure is known as arthroscopic shoulder replacement.

At each stage of the arthroscopic shoulder surgery, the surgeon is guided by an image displayed on the television screen. This is a minimally invasive procedure that ensures a quick recovery.

The shoulder has three bones, namely:

• the clavicle (the collarbone),
• scapula (the shoulder blade),
• and humerus (the upper arm bone). 

 A rotator cuff tear, articular cartilage, labrum and surrounding soft tissues can be the cause of pain in the shoulder joint. These areas can get damaged or distorted as a result of some accident. The actual cause of pain can be diagnosed with the help of a shoulder arthroscopy. Sometimes, age-related wear and tear can is also responsible for shoulder joint-related pain and problems.

Symptoms of a shoulder injury include excessive pain in the shoulder joint and stiffness in the shoulder joint that may hinder easy movement of the arm around the shoulder joint. The patient may experience trouble while sleeping with the affected shoulder on one side. Slight swelling can also be observed physically in the joint region. 

 A physician may recommend a shoulder arthroscopy if your shoulder does not respond well to other alternative treatments such as exercising and physiotherapy. Common rotator cuff surgery can be used to conduct rotator cuff repair, removal or repair of the labrum, repair of ligaments and recurrent shoulder dislocation, and bone spur removal. Some of the less common procedures may include fracture repair, cyst excision, and nerve release.

Step by step Procedure Breakdown of Shoulder arthroscopy

• A member of the anaesthesia team will speak to the patient to explain the options for anaesthesia. Regional nerve blocks are usually employed to perform shoulder arthroscopy.  An anaesthetic is employed additionally during the surgery to control pain after completion of the procedure.
• Due to the fact that patients do get uncomfortable lying in one single position for a very long period of time, some surgeons choose to combine both nerve blocks and light general anaesthetic.
• Less than an hour is required to complete shoulder arthroscopy procedure on a patient. Depending on the health of the patient, an arthroscopic shoulder surgery can be performed on an outpatient basis or may require a stretched stay in the hospital
• The position of the patient is set in a way that the surgeon gets a quick and easy access to the shoulder and easily monitors the progress on the monitoring screen which displays the images taken by the camera attached to the arthroscope.
• Once the patient is positioned, the surgical team works to remove unwanted hair in the region. To cleanse the skin, the surgical team may apply some antiseptic and cover the arm with sterile drapes. The forearm is placed inside a holding device to ensure that the arm stays in place during the procedure.
• To inflate the joint, the surgeon injects some amount of fluid in the joint. This ensures that all the structures of the shoulders are visible through the arthroscope. A small puncture is created to insert the arthroscope.

Images captured by the camera from the arthroscope is directly visible on the monitor in front of the surgeon. The images allow the surgeon to understand the extent of damage and subsequent repair required.

Once the problem is clearly understood, the surgeon inserts surgical instruments through other incisions made in e shoulder. Specific instruments for cutting, grasping, suture passing, knot tying, or shaving are inserted as per the requirement. With the help of sterile strips, the surgeon closes the incision once the job is done.

What to expect after shoulder arthroscopic surgery?

• Aftercare and recovery after shoulder arthroscopy are any days simpler as compared to other open surgeries. One may be discharged on the same day of the procedure. However, it may take a few weeks for complete healing to take place.
• The total arthroscopic shoulder surgery recovery time varies from one patient to the other. Some level of pain may remain for a week. However, it can be counteracted with some ice rub.
• Apart from that, medicines are prescribed by the doctor to take care of the pain. You may also find comfort sleeping in reclining chairs for a week. After a week, the large bandages can be replaced with smaller band-aids. A sling will be required for some time or as advised by your doctor.
• A complicated surgery may also demand some time with a physiotherapist. There may be a slight pain that may occur from time to time, but otherwise, the problems once solved should not return back to haunt you.