Name: Endoscopic Excision of the Peroneal Tubercle Using the NanoScope™ Visualization System
Uploaded: 2020-05-08T00:00:00Z
Channel: Arthrex
Description: Phinit Phisitkul, MD (Sioux, IA), performs an endoscopic excision of the peroneal tubercle using the NanoScope™ operative arthroscopy platform.

<p>Phinit Phisitkul, MD (Sioux, IA), performs an endoscopic excision of the peroneal tubercle using the NanoScope™ operative arthroscopy platform.</p>

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VID1-000929-en-US | A | Endoscopic Excision of the Peroneal Tubercle Using the NanoScope™ Visualization System

Phinit Phisitkul

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A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

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Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

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Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

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Endoscopic Excision of the Peroneal Tubercle Using the NanoScope™ Visualization System

This is a skin landmark. Fibulock as outlined here. This is peroneal tubercle. This is an outline that allows us to identify Peroneus brevis in the front. Proedge longus in the back. Usually the portal is about two centimeters proximal to the lateral malleolus. As the proximal portal and two centimeters distal to the tip of the lateral malleolus, as the distal portal is two portal. For this purposes, just have a knife, please. I, I mark also the proximal portal, so use hemostat to actually allow opening of the fascia, allowing us to put the camera in easier. Now we use the cannula. I use blunt cannula for this purpose to address prominent perineal tubercle and also tenosynovitis longus in particular in this area. So I aim the NanoScope, trocar and cannula into the peroneus longus tendon sheath is just posterior to the palpable perineal tubercle. As you can see here, I actually look from proximal to distal. It's a endoscopy of the perineal tendon. This is the longus. And this is the septum between longus and brevis. When you have irritation of prominent retinaculum this is what is blocking and what is causing pain. So I'm going to put a distal portal in this area. Now I get a hemostat into the area of my, of my portal. So you can see that this is the longus tendon. This is the floor of the longus, and this is the prominent perineal tubercle. This is a septum brevis. So you can see that peroneus longus tendon all the way to the distal aspect. This is when they make a turn and go into the underneath the cuboid actually travel underneath the bottom of the foot later on. So this is the sign of four that indicate the maximum excursion and maximum reach that we can do. Arthroscopically. So you can see the picture of the foot from the outside. You see how the how deep we go. And this is the as far as loose bodies or loose or any foreign body would come in to the peroneus longus tendon sheath. Now back off the ProEAS longus endoscopy a little bit more. Now we're going to go back into a more narrow area that we would identify and release the retinaculum. Now I put a chevron in to the same plane. I think the schedule to release the retinaculum is called inferior perineal inoculum at this point. So we're going to back off the. Back of the camera a little more. And then we're going to keep shaving the tissue. So they hold it this way. Now allowing to allowing me to keep my portal very securely on the structure I want to breathe. This is after we debrided inferior perineal retinaculum already. So we're doing this. We expose the perineal tubercle into view some more. And any bone spur at the perineal tubercle can be debrided, as shown in this step. So we are showing the Peroneal tubercle. See how I snap on top of it? So this is the exposure after we complete the retinaculum release. The debridement is going to continue on the soft tissue a little bit, and now we can expose some bone. Underneath is the bony structure that need to be debrided. We are completing the debridement of the perineal tubercle and release of the inferior peroneal retinaculum. Pretty much this is done with the place longus. The compression of the prominent peroneal tubercle and irritation of the longus, and the lateral aspect of the calcaneus wall.

Endoscopic Excision of the Peroneal Tubercle Using the NanoScope™ Visualization System

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