The course
Dr Cutbush attended a live shoulder surgery course in Annecy, France, in June 2015. The course, chaired by Dr Lafosse, is built around performing complex shoulder surgery in real time.
Live surgery is a demanding format for the operating surgeon, but it conveys the handling and the decision-making in a way a recorded or described case does not.
How a live surgery course works
At a live surgery course, operations are performed in the host hospital's theatres and transmitted to a lecture theatre where the audience watches, with a moderator putting questions to the operating surgeon as the case proceeds. The surgeon explains what is being done and why while doing it, and has to justify each decision to a room of colleagues.
The format exists because an edited video shows what was intended rather than what happened. A live case includes the unexpected findings, the moments where a plan is changed, and the handling that reveals how much tension is being put on a repair or how a difficult exposure is managed. None of that survives editing. Courses of this kind are run under the same clinical governance as any other operating list, with the patient's interests taking priority over the teaching, and the format is used mainly for complex cases where there is genuinely something to learn.
The arthroscopic Latarjet instruments
Dr Cutbush also met the engineers who designed the second-generation arthroscopic Latarjet equipment and reviewed the instruments with them. The arthroscopic version of this operation depends heavily on purpose-designed instruments, so sessions with the people who design them are directly useful.
The Latarjet procedure is an operation for a shoulder that dislocates repeatedly where bone has been lost from the front rim of the socket. A small piece of bone, the coracoid, is transferred with its attached tendon to the front of the socket, which deepens the socket and adds a restraining sling of soft tissue. Performing it arthroscopically means doing all of that through small portals with a camera rather than through an open incision, which requires the bone to be cut, moved, positioned and fixed using instruments passed down those portals. The guides and fixation devices are therefore not accessories to the technique, they are what makes it possible, and refinements between generations of instruments change what can be done reliably. Whether the procedure suits a particular shoulder depends on the examination and the imaging. Individual results vary.
Related information
- Our post on visiting Dr Lafosse in Annecy
- Our shoulder instability page
- Latarjet and labral repair
- Anterior instability