Arthroscopic SLAP Repair

Shoulder Scope SLAP 2




1. Establish portals


A.  Posterior portal for viewing


B.  Anterior portal

- need to keep low and away from biceps, otherwise difficult to get around biceps

- for suture passage, if in combination with bankart repair often use AI portal instead of AS


SLAP repair anterior portal


C.  Anterosuperolateral portal / Wilminton for insertion of anchors

- insert spinal needle first

- anterolateral border acromion

- needs to be close to acromion to get angle over humeral head

- check with needle

- need best angle to insert anchors to anterior and posterior aspect of biceps

- passes through supraspinatous

- use knife to cut in line with fibres

- insert portal


SLAP Repair Port WilmingtonShoulder Portal WilmingtonShoulder SLAP Repair Portals


2.  Prepare insertion

- shaver via anterior portal

- debride frayed labrum

- mobilise biceps tendon

- debride bony base to create ledge and bleeding bone


Shoulder SLAP Preparation Base


3.  Anchors


Drill and insert via Wilminton portal

Usually 3 anchors is a minimum



- insert anchor

- suture through each cannula

- limb through W portal will be the suture limb that is passed

- suture passer through anterior portal (right angled for left shoulder)


SLAP Anchor InsertionShoulder SLAP Repair Suture Management


Anterior anchor

- best to pass the suture passer above the biceps to get good bite

- retrieve sutures and tie from port of Wilmington


SLAP Repair Suture PasserSLAP repair Anterior AnchorSLAP Repair anterior anchor 2


SLAP Anchor 1SLAP Tie anterior anchor


Posterior 2 anchors

- pass suture passer under biceps


SLAP Vertical MattressSLAP Second Anchor


SLAP third anchorSLAP 3 anchor repair


Can suture Portal of Wilminton if desired


Portal WilmingtonWilminton Repair 1Wilminton Repair 3


4.  Dfficult posterior anchors


Camera through anterior / anterosuperiorlateral portal


A.  Place anchor through posterior portal

- does not always give good angle


SLAP repair posterior portal


B.  Trans infraspinatous Portal


SLAP Insertion Posterior AnchorsSLAP Posterior SuturesSLAP Posterior Repair