Supine-Position Shoulder Arthroscopy Using the Anterior Portal as the Initial Approach

Traditional shoulder arthroscopy mostly adopts the beach chair position or lateral decubitus position. Beach chair position is associated with the risk of cerebral hypoperfusion due to the vertical distance between the carotid artery and the heart, whereas lateral decubitus may induce brachial plexus palsy caused by excessive traction. Both positions demand special operating tables, which raises equipment costs and complicates anesthetic management. We describe supine-position shoulder arthroscopy using the anterior portal as the initial approach. The technical procedure is carried out in a supine position throughout the whole process, with relevant operations implemented via the anterior portal approach. This technique is safe, efficient, and easy to promote, which provides a reliable alternative to traditional surgical positions for shoulder arthroscopy.