Arthroscopically Assisted Latissimus Dorsi Tendon Transfer in Beach-Chair Position  Viktoras Jermolajevas, M.D., Bartlomiej Kordasiewicz, M.D., Ph.D.  Arthroscopy Techniques  Volume 4, Issue 4, Pages e359-e363 (August 2015) DOI: 10.1016/j.eats.2015.03.014 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 Creation of space for transfer passage into subacromial space. Posterolateral view, with shaver in posterior portal (right shoulder with patient in beach-chair position). The dotted line shows the future dissection plane. (Del, deltoid muscle; pAx, posterior branch of axillary nerve; pLTr, posterior part of long head of triceps tendon; Tm, teres minor muscle.) Arthroscopy Techniques 2015 4, e359-e363DOI: (10.1016/j.eats.2015.03.014) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 Arthroscopic latissimus dorsi tendon harvesting. Anterior view from anterosuperior portal, looking inferiorly in plane of humerus (right shoulder with patient in beach-chair position). An electrode is in the suprapectoral portal. The superior part of the latissimus dorsi tendon insertion has just been released, with the inferior part still attached. (Con, conjoined tendon; PecM, pectoralis major tendon; pLDT, partially released latissimus dorsi tendon; Rn, radial nerve; TBL, biceps longus tendon; 3S, 3 sisters [anterior circumflex vessels]; TM, teres major muscle.) Arthroscopy Techniques 2015 4, e359-e363DOI: (10.1016/j.eats.2015.03.014) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 Open dissection of latissimus dorsi tendon and muscle (right shoulder with patient in beach-chair position). The arm is fully abducted. The posterior border of the deltoid is pulled up with a retractor. (AF, axillary fold; B, balloon of Foley catheter; LD, latissimus dorsi with 2 Krackow stitches; TM, teres major.) Arthroscopy Techniques 2015 4, e359-e363DOI: (10.1016/j.eats.2015.03.014) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 4 Latissimus dorsi tendon (LD) pulled into posterior portal (P). Subacromial view from posterolateral portal (right shoulder with patient in beach-chair position). (Del, deltoid muscle; INF, remnant of infraspinatus.) Arthroscopy Techniques 2015 4, e359-e363DOI: (10.1016/j.eats.2015.03.014) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 5 Final view from anterolateral portal (right shoulder with patient in beach-chair position). The latissimus dorsi tendon is fixed onto the top of the greater tuberosity (GT). The rotator cuff remnants (RC) are approximated to the medial edge of the transfer to close the joint space. (LDT, transferred latissimus dorsi tendon.) Arthroscopy Techniques 2015 4, e359-e363DOI: (10.1016/j.eats.2015.03.014) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions