Endoscopic Exploration of a Brachial Plexus Injury

Based on the experience of endoscopic operations successfully performed for other purposes in other medical fields, some authors suggested that endoscopic exploration of the brachial plexus might be feasible. The aim of this paper was to report an exploratiionmanaged by endoscopy and neurolysis with a favorable evolution.

The patient was placed in dorsal decubitus, and the head was positioned in hyperextension and turned in the opposite direction of the injured plexus. Three incisions of 2.0 cm were made. The first one (medial) was placed at the point where the external jugular vein joins the subclavian vein. The second one (superior) was made at the anterior border of the trapezius muscle. The third incision (lateral) was placed at +/− 5 cm from the first incision just above the clavicle. They used rigid 0 and 30-degree cameras connected to a digital video recorder. The visualization with the endoscope was magnified and the dissection could be performed very precisely.

They were able to visualize the entire brachial plexus, and did not note any particular difficulty in freeing the rootlets from the fibrous tissue.

The author believed that this report confirms the feasibility of brachial plexus surgery in a clinical setting. In this manner, the needed experience will be gained to suggest the role of this technique in brachial plexus injuries.