ARTHROSCOPY I Dr.RAJAT JANGIR JAIPUR #aclsurgeryjaipur #aclsurgeryhindia #aclsurgerytaekwondo Acl reconstruction in jaipur | Acl reconstruction in taekwondo | Acl injury in football player surgery | Acl reconstruction surgery in football | acl surgery | Acl surgery ke baad physiotherapy | Acl surgery in jaipur | acl surgery recovery | Best acl surgeon in jaipur | Best ligament doctor in hindi | Best acl surgeon in india | Meniscus repair surgery in jaipur | Sports injury doctor | Acl injury in football players | Acl injury in taekwondo | acl tear | Best knee surgeon in jaipur #allinsideacl #internalbrace #drrajatjangir #bestaclsurgeon #aclexpert #bestkneesurgeon To Know more about ACL Injury, Click the links below: 1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all" https://youtu.be/oWkIr8IXvr8 2. Everything about ACL Injury tear surgery in Hindi I https://youtu.be/bqpjkAkwZ14 3. Best Screw for ACL tear surgery in Hindi https://youtu.be/1LGpU1NHiIs 4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir https://youtu.be/SIAPWiMbOqs 5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ? https://youtu.be/NEJRPKskJTI 6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ? https://youtu.be/EXpgy19Jxzw 7. PRP injection therapy in Partial ACL TEARs https://youtu.be/qyG1EYgS87E Dr.RAJAT JANGIR(Asso Prof.) Senior Consultant Arthroscopy and Joint Replacement (Specialist in Shoulder Knee Hip Surgery) Ligament and Joints Clinic 67/34 Mansarovar Jaipur Whatsapp: shorturl.at/gnAEP Appointment: +91 8104855900 Email: ligamentsurgeon@gmail.com Google Page: https://g.page/KNEE-Shoulder-SURGERY?... Facebook: https://www.facebook.com/Ligamentandj... * Vast experience and specialisation in the field of Arthroscopy and sports surgery. * M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad * Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea * Diploma in Sports Medicine from InternationaI Olympic Committee * Invited as Athlete Medical Doctor at Rio Olympic 2016 * Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'

1. Arthroscopy
Set up and Instrumentation
DR.RAJAT JANGIR
CONSULTANT ARTHROSCOPY SURGEON
MAHATMA GANDHI HOSPITAL, JAIPUR

2. LEARN BASICS
DRIVE SLOW
DON’T DRIVE THROUGH
BUSY ROADS

5. The Basics…
• Arthroscope
• Lighting
• Instrumentation.

6. Arthroscope
• Hopkin Rod Lens System
Length 18mm
Diameter 4mm (1.7 to 4 mm)
Viewing angle

7. Viewing Angle

8. 0 °
Straight view not recommended
30 °
Increase the field of vision
(90 )
Viewing angle

9. 70 °
For viewing special regions

10. Barrel length
• Compromise between reach and control
• 18mm recommended for Knee

11. Video Camera System
• Single Chip
• 3 Chip
• HD
• Ease of handling
• Mechanism of
coupling
• Built in Camera
functions

12. Trochar and Sheath
• One or two spigots
• 6 mm

13. Light

14. Light cable
• Light Source
– Xenon
• Light Cable
– Fiberoptic
– Liquid

15. Monitor

16. Instrumentation
• Probe
– Finger and eye
• Triangulation
• Rendezvous

17. Probe
• Feel the consistency of a structure
• Determine the depth
• To maneuver loose bodies
• Use the elbow

18. Mechanical Instruments
• Basket forceps
– Straight
– Curved
– Angled
• Grasping forceps
• Arthroscopic knife
• Arthroscopic Scissors

19. Basket Forceps
• Open base that permits the tissue to drop free within
the joint
• Subsequently removed from the joint by suction
• 3-5mm sizes with straight or curved shaft
• Usually used for trimming the peripheral rim of the
meniscus

20. Scissors
• 3-4 mm in diameter
• Jaws : straight or hooked
• Hooked scissors are preferred
– Pulling the tissue rather than pushing away
• Right and left curved

21. Motorized Instruments
• Shaver
– Control unit
– Connecting cable
– Hand piece
– Blade
– Suction

22. Shaver Blade
• Outer hollow sheath
• Inner rotating cannula with corresponding
windows

24. Electrosurgical instruments

25. Special instruments
• Chisel
• files/ rasps
• Curette
• mirror

26. Tourniquet

27. Fluid Distension
Each foot elevate from the level of the joint - 22 mmHg pressure

28. Arthroscopy Cart

29. Supine position for Arthroscopy
monitor
Side support
Foot rest

30. Leg Holder Position for Arthroscopy
monitor
Lithotomy
Thigh support

31. Positioning devices

32. Sterilization

33. Care and Sterilization of Instruments
• Fiberoptic arthroscopes and cables
Best method is
– Gas (ethlyene oxide) :1 hour
Most commonly used
– Activated glutaraldehyde (Cidex)
• Knives, graspers, basket forceps, cannulas
Steam autoclave

34. What could be wrong?
• No image on screen (Black Screen)
• Light source is turned off
• No power supply to monitor
• Video camera lens is not clear
• No input to Monitor (Blue or Multi-coloured Bands)
• Input is improperly plugged
• Wrong format
• Malfunctioning Video

35. • Blurred image
– Camera not focused
– Improper fluid inflow
– Improper suction, turbid fluid
– Cameral head is not clear
• Joint looks strange
– Non anatomic position of scope
What could be wrong?

36. • Red Out !
– Improper Tourniquet
– Vigorous suction
• Shaver not function
– Poor suction
– Improper speed
– Blunted or blocked blade
What could be wrong?