**3. Instruments**

A conventional arthroscopy setup is used. Either a hanger or a coil shaped lifter is needed. The hanger is shaped in a semi-circular, similar to those used in infantile gasless laparoscopic surgery (Takasago Medical Industry, Tokyo, Japan). The coil-shaped lifter is created from an endotracheal tube stylet (Muranaka Medical Instruments, Osaka, Japan). The tip end is bent manually to form a spiral shape, creating a coil about 5 cm in diameter, with about 3 loops (Fig 1).

Once pulling the lifter, the working space is established. Care must be taken to avoid inserting the end of the hanger into the underlying muscle. Dry arthroscopy can be

Fig. 2. Coil shaped lifter is inserted into the subcutaneous space

Fig. 3. Subcutaneous space created by the lifter.

performed in the subcutaneous working space created by the lifter (Fig.3,4). Lastly, the hanger is removed by turning it in the opposite direction.

Fig. 1. A: Semi-circular hanger, B: Coil shaped lifter
