Wrist Arthroscopy Set - up and Equipment

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Wrist ArthroscopySet - up and Equipment

• Paul R Stuart
• Hand Upper Limb Surgeon
• Newcastle upon Tyne

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Anaesthesia

• general anaesthesia
• majority, d/c, quick
• regional block
• patient can observe, dead arm
• local anaesthesia
• tourniquet pain, incomplete anaesthesia, finger
  pain

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Theatre set-up

• size
• layout
• lighting

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Traction / Suspension

• vertical position
• traction to open joint
• tower / suspension system
• shoulder holder

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Traction / Suspension
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Traction / Suspension
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Traction / Suspension

• re-usable finger traps
• plastic / metal

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Prep Drape

• un-dyed prep solution
• hand off prior to taking infusion fluid
• sterile finger traps (multi-use)
• waterproof drapes
• top drapes

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Prep Drape
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Tourniquet

• Pros
• no portal bleeding, no interference with vision
• support for weights
• Cons
• ? Loss of definition of colour
• pain in conscious patient (lt15 mins)

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Fluids

• Gravity fed 1 litre bag n/s
• joint filled via 3/4 / MCR portals using 20 ml
  syringe
• bubbles are the enemy!

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Basic equipment

• Marking pen
• 15 blade
• green / white needles
• small straight clip
• 2.5mm, 25o small joint scope
• probe (1.5mm tip)

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Basic equipment
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Basic equipment
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Basic equipment
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Simple Operative Equipment

• Suction punch
• small graspers
• small power instruments

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Advanced Operative Equipment

• Procedure specific (eg tfc)
• electrodes
• distal radial fracture fixation
• scaphoid fixation