Arthroscopic-assisted exploration of the axillary nerve through a posterior open approach: A novel technique

Andrés A. Maldonado, Robert J. Spinner, Allen Thorp Bishop, Alexander Yong-Shik Shin, Bassem T. Elhassan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction Previous studies have described a segment of the axillary nerve (AN) that cannot be surgically explored through standard open surgical approaches (blind zone). This study aimed to evaluate the feasibility of combining the standard posterior approach to the AN by using an arthroscope to visualize all segments of the AN. Material and methods Four fresh-frozen shoulders in two adult human torsos were included in the study. A standard posterior approach was performed on each shoulder, and a dry arthroscopy was performed through the surgical opening in an attempt to visualize all the segments of the AN. A surgical clip was placed at the most proximal and anterior segment of the AN that could be visualized with the arthroscope. A standard open deltopectoral approach was then performed to determine the exact location of the surgical clip and its relation to the origin of the AN. Results All segments of the AN (including the blind zone) were visualized from the quadrilateral space to their origin from the posterior cord in all four specimens. The surgical clip was found at an average of 1 cm (range from 0.5 to 1.5 cm) from the origin of the AN from the posterior cord. Conclusions This cadaveric study shows that it is feasible to visualize all segments of the AN (including the blind zone) using this novel approach that combines the use of the standard posterior approach to the AN with dry arthroscopic exploration. Clinical studies are necessary to evaluate the utility of this novel approach.

Original languageEnglish (US)
Pages (from-to)625-627
Number of pages3
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume70
Issue number5
DOIs
StatePublished - May 1 2017

Fingerprint

Arthroscopes
Surgical Instruments
Bursitis
Torso
Arthroscopy

Keywords

  • Axillary nerve
  • Axillary nerve exploration
  • Blind zone
  • Open-arthroscopic approach

ASJC Scopus subject areas

  • Surgery

Cite this

Arthroscopic-assisted exploration of the axillary nerve through a posterior open approach : A novel technique. / Maldonado, Andrés A.; Spinner, Robert J.; Bishop, Allen Thorp; Shin, Alexander Yong-Shik; Elhassan, Bassem T.

In: Journal of Plastic, Reconstructive and Aesthetic Surgery, Vol. 70, No. 5, 01.05.2017, p. 625-627.

Research output: Contribution to journalArticle

@article{d58fc9f15bc14f258eebf76b39b1802f,
title = "Arthroscopic-assisted exploration of the axillary nerve through a posterior open approach: A novel technique",
abstract = "Introduction Previous studies have described a segment of the axillary nerve (AN) that cannot be surgically explored through standard open surgical approaches (blind zone). This study aimed to evaluate the feasibility of combining the standard posterior approach to the AN by using an arthroscope to visualize all segments of the AN. Material and methods Four fresh-frozen shoulders in two adult human torsos were included in the study. A standard posterior approach was performed on each shoulder, and a dry arthroscopy was performed through the surgical opening in an attempt to visualize all the segments of the AN. A surgical clip was placed at the most proximal and anterior segment of the AN that could be visualized with the arthroscope. A standard open deltopectoral approach was then performed to determine the exact location of the surgical clip and its relation to the origin of the AN. Results All segments of the AN (including the blind zone) were visualized from the quadrilateral space to their origin from the posterior cord in all four specimens. The surgical clip was found at an average of 1 cm (range from 0.5 to 1.5 cm) from the origin of the AN from the posterior cord. Conclusions This cadaveric study shows that it is feasible to visualize all segments of the AN (including the blind zone) using this novel approach that combines the use of the standard posterior approach to the AN with dry arthroscopic exploration. Clinical studies are necessary to evaluate the utility of this novel approach.",
keywords = "Axillary nerve, Axillary nerve exploration, Blind zone, Open-arthroscopic approach",
author = "Maldonado, {Andr{\'e}s A.} and Spinner, {Robert J.} and Bishop, {Allen Thorp} and Shin, {Alexander Yong-Shik} and Elhassan, {Bassem T.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.bjps.2017.01.012",
language = "English (US)",
volume = "70",
pages = "625--627",
journal = "Journal of Plastic, Reconstructive and Aesthetic Surgery",
issn = "1748-6815",
publisher = "Churchill Livingstone",
number = "5",

}

TY - JOUR

T1 - Arthroscopic-assisted exploration of the axillary nerve through a posterior open approach

T2 - A novel technique

AU - Maldonado, Andrés A.

AU - Spinner, Robert J.

AU - Bishop, Allen Thorp

AU - Shin, Alexander Yong-Shik

AU - Elhassan, Bassem T.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Introduction Previous studies have described a segment of the axillary nerve (AN) that cannot be surgically explored through standard open surgical approaches (blind zone). This study aimed to evaluate the feasibility of combining the standard posterior approach to the AN by using an arthroscope to visualize all segments of the AN. Material and methods Four fresh-frozen shoulders in two adult human torsos were included in the study. A standard posterior approach was performed on each shoulder, and a dry arthroscopy was performed through the surgical opening in an attempt to visualize all the segments of the AN. A surgical clip was placed at the most proximal and anterior segment of the AN that could be visualized with the arthroscope. A standard open deltopectoral approach was then performed to determine the exact location of the surgical clip and its relation to the origin of the AN. Results All segments of the AN (including the blind zone) were visualized from the quadrilateral space to their origin from the posterior cord in all four specimens. The surgical clip was found at an average of 1 cm (range from 0.5 to 1.5 cm) from the origin of the AN from the posterior cord. Conclusions This cadaveric study shows that it is feasible to visualize all segments of the AN (including the blind zone) using this novel approach that combines the use of the standard posterior approach to the AN with dry arthroscopic exploration. Clinical studies are necessary to evaluate the utility of this novel approach.

AB - Introduction Previous studies have described a segment of the axillary nerve (AN) that cannot be surgically explored through standard open surgical approaches (blind zone). This study aimed to evaluate the feasibility of combining the standard posterior approach to the AN by using an arthroscope to visualize all segments of the AN. Material and methods Four fresh-frozen shoulders in two adult human torsos were included in the study. A standard posterior approach was performed on each shoulder, and a dry arthroscopy was performed through the surgical opening in an attempt to visualize all the segments of the AN. A surgical clip was placed at the most proximal and anterior segment of the AN that could be visualized with the arthroscope. A standard open deltopectoral approach was then performed to determine the exact location of the surgical clip and its relation to the origin of the AN. Results All segments of the AN (including the blind zone) were visualized from the quadrilateral space to their origin from the posterior cord in all four specimens. The surgical clip was found at an average of 1 cm (range from 0.5 to 1.5 cm) from the origin of the AN from the posterior cord. Conclusions This cadaveric study shows that it is feasible to visualize all segments of the AN (including the blind zone) using this novel approach that combines the use of the standard posterior approach to the AN with dry arthroscopic exploration. Clinical studies are necessary to evaluate the utility of this novel approach.

KW - Axillary nerve

KW - Axillary nerve exploration

KW - Blind zone

KW - Open-arthroscopic approach

UR - http://www.scopus.com/inward/record.url?scp=85015703586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015703586&partnerID=8YFLogxK

U2 - 10.1016/j.bjps.2017.01.012

DO - 10.1016/j.bjps.2017.01.012

M3 - Article

C2 - 28285011

AN - SCOPUS:85015703586

VL - 70

SP - 625

EP - 627

JO - Journal of Plastic, Reconstructive and Aesthetic Surgery

JF - Journal of Plastic, Reconstructive and Aesthetic Surgery

SN - 1748-6815

IS - 5

ER -