Scope Essentials 2024-Access and Portals

Video Transcription

Video Summary

Dr. Winston Guafi from the University of Virginia discusses hip arthroscopy access, emphasizing the importance of the operating room (OR) table, which must provide adequate traction, hip manipulation, fluoroscopy compatibility, and safety for long procedures. He reviews different table options, including traditional fracture, HANA, and postless tables, highlighting the benefits of postless traction in reducing complications. Dr. Guafi stresses the significance of proper fluoroscopic imaging aligned with preoperative views for accurate deformity correction. Key technical points include ensuring muscle paralysis, venting the capsule for distraction, and having a plan for difficult joint access. Portal placement is critical, prioritizing safety from neurovascular structures, adequate spacing for instrumentation, and correct alignment relative to anatomical landmarks such as the ASIS and trochanter. The first portal’s accuracy is vital to avoid labral injuries. He advises dry initial joint visualization and troubleshooting for poor distraction and visualization. Dr. Guafi encourages fellows to master these techniques to optimize outcomes in hip arthroscopy.

Asset Caption

Frank Winston Gwathmey, Jr., M.D.

Keywords

hip arthroscopy

operating room table

postless traction

fluoroscopic imaging

portal placement