The course
Taking part, with Ashish Gupta, in the 7th B&B Arthroscopy Course in Kathmandu, Nepal. Dr Cutbush will perform a live surgery and is a keynote speaker at the course.
A course now in its seventh year suggests arthroscopic shoulder surgery is becoming established locally rather than being demonstrated as a novelty, which is the point of running them repeatedly in the same place.
With thanks to the organising committee, and to QUASR, the ARC Training Centre for Joint Biomechanics, St Andrew's War Memorial Hospital, QUT and The University of Queensland.
What shoulder arthroscopy is
Arthroscopy means operating inside a joint using a camera. A small telescope is passed through a portal a few millimetres across, the image is displayed on a screen, and instruments are passed through further portals to work on the structures inside. In the shoulder it is used to repair the rotator cuff, to repair or reconstruct the structures that stabilise the joint, to release a contracted joint lining, and to deal with the biceps tendon, among other things.
Compared with open surgery it avoids dividing muscle to reach the joint and allows the whole of the inside of the joint to be inspected. It is also a separate technical skill, performed from a screen with long instruments, and it has to be learned as such. Individual results vary.
Why live surgery is part of a course
Live surgery means an operation performed in theatre and transmitted to the course audience, with commentary and questions as it proceeds. It shows what an edited video does not: how the patient is positioned and prepared, how the portals are planned, the order the steps are taken in, and how a difficulty is dealt with at the moment it appears.
Why courses are repeated in the same place
Running a course in the same centre year after year is deliberate. Surgeons who attended earlier editions have been performing the operations themselves in the meantime, so their questions move from how a technique is done to the specific problems they have run into. A faculty that returns can also follow up on what was taught previously, which a single visit cannot do. Building that capability locally matters more than any one demonstration, because the surgery then continues after the visitors have left.
Related information
See our other Nepal posts, including the B&B Shoulder Arthroscopy Course and live surgery in Kathmandu. See also our rotator cuff repair, shoulder instability and shoulder surgery pages.