Lateral Patient Positioning for Shoulder Arthroscopy

1. Pad and secure patient

1. Once asleep, patient is turned onto their side and axillary roll is placed 3 finger widths below axillary space
2. Patient’s head is placed on circular pad and all sensitive areas are padded, namely between the thighs and shins so the fibular head does not compress surrounding neurovascular structures
3. A belt and surgical tape are used to secure the patient onto the bed in the lateral position to prevent movement during the procedure

2. Draping and lateral positioner setup

1. 1015 U-drapes (3M) are used for the original draping around the operative arm
2. The lateral positioner (Arthrex) is attached to the side of the bed the patient is facing such that the operative arm comes across the patient body
3. After positioner setup, the patient is then draped with 1 rectangular drape over their body and 2 additional U-drapes, 1 with a pouch to collect arthroscopic fluids, that are finally covered with Ioban drapes around the perimeter to prevent water leaking underneath
4. The patient’s hand is made into a fist and secured in the hand holder by Velcro straps. The hand holder is then clipped to the sterile portion of the lateral positioner and 12.5 pounds of counterweight is applied to start, which can be increased to as much as 15 pounds
5. The axillary pad is then strapped to the end of the positioner and approximately 20 pounds of traction is applied to increase glenohumeral joint space

3. Standard shoulder arthroscopy setup

1. Standard arthroscopy setup follows, including a shoulder arthroscopy set with tubes, a shaver, Bovie tip with Colorado tip, water, cannula and outflow devices