Abstract
Patient positioning in shoulder arthroscopy is crucial for visualisation, access, neurovascular safety, and surgical efficiency. Traditionally, procedures are performed in either the Beach Chair (BC) or Lateral Decubitus (LD) positions, each offering specific advantages and disadvantages.
We introduce a new hybrid setup that combines the strengths of BC and LD positioning. The patient is placed laterally with a 60° posterior tilt, stabilised with beanbags and straps. The non-operative limb rests on an arm board, while the operative limb is supported by a stabilising device or light traction (4–5 lb). The surgical table is inclined in an anti-Trendelenburg position (30–45°), with optional posterior tilt at the surgeon's preference. This positioning provides excellent joint space, anatomical orientation, and optimised visualisation while reducing traction-related complications.
This hybrid position offers the visualisation and working space of LD, while incorporating the ergonomic and teaching benefits of BC. It presents a safe, practical, and reproducible setup for shoulder arthroscopy.