Turbulence control as a factor in improving visualization during subacromial shoulder arthroscopy

Bleeding in the subacromial space is an annoying but ever-present impediment to visualization during arthroscopic subacromial procedures. Direct (thermal electrocautery) and indirect (hypotensive anesthesia, arthroscopic pump) means of bleeding control have been used with varying degrees of success. However, the simplest technique of all has been ignored until now. Application of Bernoulli's Principle to achieve turbulence control by means of digital pressure over a leaking portal can quickly and easily enhance visualization.