The technic of the Bankart operation. A modified reinsertion technic

A modified technique of reinsertion of the capsule to the bony rim of the glenoid was developed and performed in 57 patients with recurrent anterior dislocation of the shoulder joint. The technique is described in detail. The principal idea of this modified technique is to suture the lateral flap of the capsule into a small sulcus, which is chiselled into the transition zone between the cartilage of the joint and the bony rim of the glenoid. From the bottom of the sulcus four holes are drilled just below the corticalis of the glenoid rim with a dental drill. The capsule is fixed by two U-sutures transosseously. The advantages of this technique are: (1) stable capsular barrier along the rim of the glenoid reinserted by two strong U-sutures; (2) no step between the cartilage of the joint and the reinserted capsule (a Hill-Sachs lesion cannot hook in at the Bankart lesion); (3) the sutures are extra-articular; (4) the lateral flap of the capsule must not be shortened, and therefore full shoulder motion can be obtained; (5) the tendon of the subscapularis muscle is restored to its original position on the lesser tuberosity; (6) a short period of postoperative immobilization. In accordance with the standard rating scale of Rowe, 31 patients were graded as having excellent results, 8 good, none fair, and none poor.     

The technic of operative cholangiography

1.

1. Operative cholangiography is a means of visualizing the extrahepatic biliary system by contrast roentgenography during the surgical exploration of these structures. If the gallbladder and bile ducts are filled with a suitable contrast solution, an accurate radiographic pattern of the entire extrahepatic biliary system can be obtained. Pathologic lesions such as stones, kinks, strictures and neoplasms produce recognizable deformities. Anatomic aberrations in size, shape and position of the bile duct can be readily detected. This information is necessary for the judicious selection of the proper remedial operation.