Preparations

4 Arm positioning devices 4 Horseshoe-shaped headrest 4 Remove the Gilchrist bandage

4 Shaving in the area of the incision and preoperative skin cleansing Positioning

4 Beach-chair operating table position 2 or universal operating table with shoulder plate

4 Anaesthetic preparation and induction in supine position with 2 adapted arm positioning devices 4 Crosswise positioning of the operating table in the theatre 4 When positioning the patient, take appropriate measures to prevent decubitus at areas which are subjected to pressure 4 The patient's shoulders end at the upper edge of the operating table 4 Bring the operating table gradually to the half-sitting (beach-chair) position

4 Raise the back plate and alternately lower the head of the complete operating table until the final position is reached 4 Change the Bowden cable over and lower the legs to the horizontal (system 1120)

4 Position the head on a horseshoe-shaped headrest and fix with transparent plaster right across the forehead or use a head holder for shoulder operation (U-shaped helmet) 4 Position the infusion arm on an arm positioning device 4 Cover the arm on the side being operated while leaving it free to move and position it at the body with arm protection or place it on the arm positioning device

4 Apply the neutral electrode and connect to the HF surgery device 4 Fit the thorax support to the rail of the shoulder plate 4 Arrange self-adhesive covers for preoperative skin disinfection 4 Position the operating lights 4 Patient warming system

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