Name: The Use of the Arthrex Viper™ Suture Passer
Uploaded: 2012-05-18T00:00:00Z
Channel: Arthrex

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VCD-1051 | A | The Use of the Arthrex Viper™ Suture Passer

Stephen S. Burkhart

Human

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.

Operationstechnikvideos

Surgical Technique Videos

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

Vídeos de técnicas cirúrgicas

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

Videos de técnicas quirúrgicas

The Use of the Arthrex Viper™ Suture Passer

I'm Steve Burkhart, and I want to show you some technique tips on use of the Arthrex Viper suture passer. The Viper is a unique suture passer that can pass braided suture through the rotator cuff or through the capsular tissues. It has a trigger that controls the tray in the lower jaw that will deliver suture up to a slot in the jaw, or retract it away from that slot. The suture is placed in the slot. The suture is retracted away from that slot. It doesn't get captured by the jaw in that position. The jaw is closed and now the trigger is activated, and the tray pushes the suture into the jaw. And the jaw then pulls the suture out through the top. We'll show an example of a The subscapularis repair using the Viper. Now you want to load the Viper near the end of the suture, so that if there is some fraying of the suture, it's near the end, and then you'll have to take out the slack by pulling on the other end as you place the instrument down into the joint. You'll see here that we'll clamp down onto the tendon, and then once it's where we want it, we'll activate the trigger. And that pushes the suture up into that upper jaw. The jaw captures it, and then you have to push the jaw forward and work it so that it pulls that suture through the tendon. Then you close the jaw. Once you're past the edge of the tendon and pull the suture out. Now we're going to load the white suture into the lower jaw. We'll put it in the slot. We'll push the trigger forward to pull it out of the way of the slot, so that the upper jaw won't capture it when the jaw is closed. We'll go into the joint and close the jaw. When the upper jaw is fully penetrated through the tendon, you'll usually feel a click. Then you activate the trigger, push the upper jaw forward, work it a little bit to free it from the soft tissue. Pull it over the edge of the tendon and then you can pull the suture out through the cannula. Now we'll simply tie the knots. We'll cut the suture and you'll see we've got a completed subscapularis repair. The Viper can also be used to place side to side sutures. In this case we're looking through a posterolateral portal at a left shoulder. The Viper is used through a lateral portal to place a suture limb through the posterior leaf. And then it's retrieved out through the lateral cannula. The other end of the suture. Limb is then threaded onto the Viper and pass through the anterior leaf. The same triggering mechanism and the same steps are used, and then this suture limb is withdrawn through the lateral portal. We can use the Viper to place sutures from an anchor after margin convergence. Here you see margin convergent sutures in place after a side to side repair. We're going to take one of the anchor suture limbs out now and put this in through the cannula. Now inside the joint we'll place this suture through the edge of the rotator cuff. You'll notice that the Viper is between the anchor and the free end of the suture to suture to keep the suture from getting tangled. We'll pull this over the edge, and then we'll now place our white suture. Pull the trigger and we'll pull up and out. Now we'll load a green suture. Notice we're near the end of the suture. We'll pull the slack out as we put the instrument down through the cannula. As we pull it through the leaf, we're working the upper jaw and we're pushing it forward so it doesn't get captured in the tendon, and then we'll pull it back. Notice the cannula. We've cut a horseshoe out of the top of it, which is a useful way to avoid having it capture the jaws together. Now through the posterior leaf, we're going to place a white suture so that we'll have a separate anchor to hold the posterior leaf down in place. So we have one anchor posteriorly, one anchor anteriorly on the margin. Convergence repairs. And we'll withdraw this out through the cannula. Now I'd like to show you a quick and easy way of placing side to side sutures. This is the left shoulder. We're bringing the Viper through a posterior portal. And we're going to place a green suture through that same posterior portal. We'll come back with a white suture and place it. And we're going to place all of our sutures through the anterior leaf first. Then we'll come back and go through the posterior leaf. So we're using the Viper for these three sutures through the anterior leaf coming in through a posterior portal. You see how we work the jaw forward as we pull through that tendon so it doesn't get captured. We'll now bring a Penetrator through the posterior leaf, and we're going to capture these sutures one at a time and bring them out through the posterior leaf. So we come in and we bring out this first suture limb out through the posterior portal. Then we'll come back in through that posterior portal again and we'll capture the next suture. So what we're doing is repeating the same steps sequentially for the anterior leaf. Then the posterior leaf in order to create our array of side to side sutures. This technique can save a significant amount of time in placing the side to side sutures. Thank you. For more information regarding this and other unique Arthrex instruments, contact your local Arthrex representative or call us toll free at 1-800-934-4404.

The Use of the Arthrex Viper™ Suture Passer

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