Shoulder Surgical Exposure workshop

The Master of Orthopaedic Surgery (MCh Orth) and Orthopaedic Science candidates attended a workshop on Shoulder Surgical Exposure organised and jointly run by Mr Aprit Jariwala (pictured right with glasses) on 2nd November 2017.

The workshop was held at the Centre for Anatomy & Human Identification (CAHID) at the main University Campus where the participants undertook the various surgical approaches themselves. Each participant had a Thiel cadaver to themselves and for every participant there was a faculty member leading them through the various exercises. Thiel embalmed cadavers were used, which is unique to the MCh (Orth) Dundee course, and affords more realistic, moveable and flexible cadavers to simulate real-life surgery. All students received a certificate of participation.

The first session of the workshop concentrated on Deltopectoral approach:

1. Surface marking of incision
2. Identification of cephalic vein and DP interval
3. Biceps tenotomy and pec majr identification
4. Subscapularis tenotomy
5. Exposure of glenohumeral joint
6. Extending the DP approach to the elbow and visualisation of the radial nerve

The second session centred on the Mackenzie approach:

1. Surface marking of the incision
2. Deltoid split and subacromial space exposure
3. Identification of cuff
4. Exposure of ‘footprint’ for cuff repair
5. Identification of axillary nerve
6. Extending the approach to the elbow and visualisation of the radial nerve

The last session of the workshop focussed on the posterior approach to the elbow joint:

1. Ulnar nerve exposure
2. Decompression and transposition
3. The tricky ‘’posterior approach to the shoulder joint.

For the first-time students had the unique opportunity of using implants in lifelike scenarios. Mr Dean Gartland from Depuy Mitek, who works closely with Mr Jariwala, kindly arranged rotator cuff anchors for the students to undertake open cuff repair and practice knot tying.

Mr Jariwala stated:

“I would personally like to thank my colleagues and fellow Faculty members, Mr Rickhuss, Mr Wigderowitz, Mr Thomas and Mr Tomasek for all their assistance in giving their time freely to demonstrate surgical techniques to the participating students. I would also would like to thank my orthopaedic trainee Mr Pete Hutchison who helped supervise the participants. I hope the students learned something new from this shoulder workshop that they can use in their own orthopaedic practice. We are currently in the process of involving more companies who can support us next year to make it even more exciting for students to be able to practice different surgical techniques.”

Professor Rami Abboud, Head of Department of Orthopaedic & Trauma Surgery added:

“On behalf of the students, and myself as Course Director, I would like to say a huge thank-you to Mr Jariwala (himself a MCh Orth, Dundee, Graduate from 2003) and the attending Faculty on the outstanding organisation of this annual workshop. It is a fantastic opportunity for our candidates to benefit from the sharing of their vast orthopaedic surgery skills. We are always obliged to Professor Dame Sue Black and all the staff at CAHID for their continued support in using Thiel embalmed cadavers which gives our students an opportunity to experience this unique approach to surgical training techniques. I would also like to state my gratitude to all those who generously bequeath their bodies to medical science for anatomical examination, research, and education and training”.

Dr Syed Natiq Hussain, a current MCh (Orth) candidate and participant of the workshop stated:

“Dear Mr Jariwala, I cannot thank you and the team enough for arranging the shoulder and arm dissection session yesterday. I had been waiting for this moment for a very long time. The last time I was around cadavers was in 2004. Dissecting on a Thiel embalmed cadaver all to myself and with a Consultant watching me, correcting me, demonstrating and guiding me at every step … I couldn't have asked for more! I am actually amazed and heartened at the way you are so interested in training us. This MCh (Orth) programme has been helping me improve on a daily basis but with what we experienced yesterday in the dissection hall, I am falling short of words to thank you Sir”.

Please note that due to our strict adherence to Thiel copyright and legal agreement we are obviously restricted as to what imagery we can show in the public domain.