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the joint open.
Traditionally, this inflow has been the work of gravity. A bag of saline is
hung on an IV pole and tubing feeds the fluid into the joint, with the pres-
sure controlled through strategic raising and lowering of the bag. The circu-
lating nurse must keep a close eye on the fluid level and replace emptying
bags in time to prevent disruption of the flow. Setting up multiple bags to
dispense fluid simultaneously but staggered can help to avoid disruption.
Arthroscopic shavers and suction devices can help to remove outflowing
fluid waste and forestall extensive post-procedure mopping and cleanup.
A number of specialized arthroscopy pump systems are commercially
available, which not only offer more precise control over fluid inflow and
capture of outflow, but also ensure balanced pressure in the joint for a
more stable operative site. This is particularly important in shoulder sur-
M I N I M A L L Y I N V A S I V E S U R G E R Y
