A day at Funabashi Orthopaedic Hospital
A day observing surgery with Dr Hiro Sugaya at Funabashi Orthopaedic Hospital in Tokyo. A large number of cases, and a good deal to learn about the finer details of shoulder surgery.
The cases
- Anatomic total shoulder replacement using the Ascend Flex system from Wright / Tornier.
- Arthroscopic Bankart repair for shoulder instability.
- Arthroscopic rotator cuff repair for a torn supraspinatus tendon.
- Global stabilisation for multidirectional shoulder instability.
A list covering that range in a single day is unusual and makes for a productive visit.
What those operations are
Each of the cases on that list addresses a different problem.
- An anatomic total shoulder replacement reproduces the normal arrangement of the joint, replacing the worn ball on the arm bone and the worn socket on the shoulder blade. It relies on the rotator cuff tendons still working.
- An arthroscopic Bankart repair reattaches the torn labrum, the cartilage rim around the socket, to the edge of the bone, for a shoulder that has dislocated at the front.
- An arthroscopic rotator cuff repair reattaches a torn tendon to its attachment on the bone, using anchors set into the bone and sutures passed through the tendon.
- A global stabilisation procedure addresses a shoulder that is loose in several directions rather than one, by tightening the capsule of the joint in more than one place.
Individual results vary, and which of these is appropriate depends on the diagnosis, the imaging and the individual patient.
Why observing a high volume practice is useful
Seeing four different operations in one day is useful in a way that seeing four of the same operation is not. The comparison is where the learning sits: how positioning, portal placement and instrument handling change between an instability case and an arthroplasty, and what the surgeon does in the same way across all of them regardless of the diagnosis. Those consistent habits are rarely written down anywhere and are usually the most transferable part of a visit.
Related information
See our pages on shoulder instability, arthroscopic Bankart repair, rotator cuff tear, rotator cuff repair, stabilisation and anatomic total shoulder replacement.