Dual-Camera Technique for Arthroscopic Rotator Cuff Repair John R. Tuttle, M.D., M.S., Paul Ramos, P.A., Manuel F. DaSilva, M.D.  Arthroscopy Techniques  Volume 3, Issue 6, Pages e647-e651 (December 2014) DOI: 10.1016/j.eats.2014.08.001 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 The patient is positioned in the left lateral decubitus position. A small to medium rotator cuff tear in the supraspinatus tendon near the rotator interval is viewed from the standard posterior portal in the glenohumeral joint of the right shoulder. An anterior working portal has been established, and a shaver has been introduced below the biceps tendon in the top image. The bottom image shows the prepared supraspinatus footprint on the humeral head. Arthroscopy Techniques 2014 3, e647-e651DOI: (10.1016/j.eats.2014.08.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 The patient is positioned in the left lateral decubitus position. A small to medium rotator cuff tear in the supraspinatus tendon near the rotator interval is viewed from the posterior portal in the glenohumeral joint. The delamination (arrow) on the articular side of the same tear from Figure 1 should be noted. The articular-sided layer of the rotator cuff (arrow) has retracted toward the glenoid relative to the bursal layer (star). This delamination and retraction may require the better visualization provided by dual cameras to ensure all layers are included in the repair. Arthroscopy Techniques 2014 3, e647-e651DOI: (10.1016/j.eats.2014.08.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 The patient is positioned in the left lateral decubitus position. A small to medium rotator cuff tear in the supraspinatus tendon near the rotator interval is viewed (A) from the posterolateral portal on the bursal side and (B) from the posterior portal in the glenohumeral joint of the right shoulder. Suture passage is being performed as viewed from both the (A) bursal and (B) glenohumeral side of the rotator cuff. The biceps tendon (asterisk) is avoided, and the articular delamination (arrow) is captured in the repair. The Mitek suture passer (stars) has been introduced from a lateral working portal, while a tissue grasper is manipulated from the anterior portal. Arthroscopy Techniques 2014 3, e647-e651DOI: (10.1016/j.eats.2014.08.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 4 The patient is positioned in the left lateral decubitus position. Repair completion of a small to medium rotator cuff tear in the supraspinatus tendon near the rotator interval is viewed (A) from the posterolateral portal on the bursal side and (B) from the posterior portal in the glenohumeral joint of the right shoulder. All layers have been captured in the repair, as confirmed by the intra-articular camera with nearly anatomic restoration of the rotator cuff to the footprint. Arthroscopy Techniques 2014 3, e647-e651DOI: (10.1016/j.eats.2014.08.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 5 The dual cameras are being used in the operating room. The patient is positioned in the left lateral decubitus position. The left screen corresponds to the arthroscope in the posterior portal, showing the glenohumeral joint and being held by the surgeon on the left. The screen on the right corresponds to the camera in the posterolateral portal, showing the subacromial bursae and being held by the surgeon on the right. A shaver has been introduced through the lateral portal and is being operated by the surgeon on the right. Arthroscopy Techniques 2014 3, e647-e651DOI: (10.1016/j.eats.2014.08.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 6 The patient is in the left lateral decubitus position. The acromion has been outlined. A camera has been inserted in the posterior portal and another camera placed in the posterolateral portal. A shaver has been introduced through the lateral portal. It should be noted that the fluid pump is located on 1 arthroscope only. Arthroscopy Techniques 2014 3, e647-e651DOI: (10.1016/j.eats.2014.08.001) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions