Carbon dioxide gas endoscopy of the deep gluteal space

Hal David Martin; Munif Hatem; Juan Gómez-Hoyos; Luis Pérez-Carro; Anthony N Khoury

doi:10.1080/08998280.2020.1776813

Carbon dioxide gas endoscopy of the deep gluteal space

Proc (Bayl Univ Med Cent). 2020 Jul 6;33(4):550-553. doi: 10.1080/08998280.2020.1776813.

Authors

Hal David Martin¹, Munif Hatem¹, Juan Gómez-Hoyos^{1

2}, Luis Pérez-Carro³, Anthony N Khoury¹

Affiliations

¹ Hip Preservation Center, Baylor University Medical Center at Dallas, Dallas, Texas.
² Clinica del Campestre and School of Medicine, University of Antioquia, Medellin, Colombia.
³ Orthopedic Surgery Department, Clinica Mompia, Cantabria, Spain.

Abstract

The treatment of hip and pelvic pain associated with abnormalities of the deep gluteal space has evolved and increasingly involves endoscopic techniques with a saline expansion medium. This investigation presents a surgical technique utilizing carbon dioxide as the insufflation medium for deep gluteal space endoscopy in 17 cadaveric hips. This technique was successful in 94% (16/17) of the hips, allowing for visualization of the sciatic nerve, posterior femoral cutaneous nerve, pudendal nerve, branch of the inferior gluteal artery crossing the sciatic nerve, piriformis muscle, hamstring tendon origin, and lesser trochanter. Our experience suggests that gas expansion presents several advantages over fluid expansion.

Keywords: Carbon dioxide gas endoscopy; deep gluteal space; ischiofemoral impingement; sciatic nerve release.