Arthroscopic Dissection and Protection of an Aberrant Suprascapular Nerve During Massive Rotator Cuff Repair

The video demonstrates an arthroscopic technique for identification, dissection, and protection of the suprascapular nerve (SSN) during massive rotator cuff repair. The SSN, closely related to the transverse scapular ligament (TSL), may present anatomical variations that heighten the risk of iatrogenic injury. In this technique, careful dissection is performed to expose the nerve, especially in cases where it courses over the TSL rather than through the suprascapular notch. Key anatomical landmarks and stepwise visualization methods are illustrated to ensure safe exposure and preservation of the SSN during procedures such as subacromial decompression, medial-row anchor placement, massive rotator cuff tears, or SSN release. Emphasis is placed on meticulous preoperative planning and intraoperative vigilance to enhance procedural safety.