A U G U S T 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 1 5
brighten dark and posterior compartments
of the joint for improved visualization.
3. Better instrumentation
Arthroscopy has changed dramatically
over the years, evolving from a diagnostic
tool to a therapeutic one, says Dr. Nho.
"Prior to the 1990s, it was a pretty basic
surgery where we would place an incision
for the portal and one for the instrument,"
he says. "Due to poor visualization, this
meant arthroscopy was mainly limited to
diagnostic cases or retrieving loose for-
eign bodies. Since then, our surgical goals
have grown and now surgeons can repair
soft tissue and cartilage, and remove bony deformities."
Just as scopes have improved to make this evolution possible, so have other
arthroscopic instruments. Shavers and burrs have gotten smaller, more
ergonomic and more efficient, and often feature suction integration that
removes the trimmed tissue and bone dust to keep the views clear.
Dr. Nho notes that these improved instruments help make new surgical tech-
niques that demand improved visualization possible, especially for hip
arthroscopy. "We're able to perform retraction and make our capsular cuts dif-
ferently, which would not have been possible 15-plus years ago," says Dr. Nho.
Dr. Pill points out that arthroscopic electrocautery options are also advancing,
giving surgeons better options for ablating or cauterizing tissue intraoperatively
and reducing bleeding that can impair their view of the joint. The latest innova-
tions are also safer, because they can operate more efficiently at lower power set-
tings, and are more ergonomic for easier use through small cannulas.
• SEEING IS BELIEVING The latest video systems might not improve outcomes,
but they can let surgeons shave minutes off their case times.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
