Table 3.

Advantages and Disadvantages of the Lateral Decubitus Position

Advantages	Disadvantages
Improved visualization of the glenohumeral joint, obviating the need to create accessory portals that disrupt the rotator cuff	Risk of neurologic injury due to applied lateral and axial traction on the operative arm (peripheral nerves and brachial plexus)
Increased working space, specifically to the inferior and posterior labrum, inferior capsule, subacromial space, and articular side of the rotator cuff	Risk of vascular injury due to portal placement, especially the cephalic vein
Allows surgeon to operate with arms at side for increased comfort and decreased fatigue (as opposed to abducted position)	Increased difficulty with intraoperative conversion to an open approach
Bubbles created by electrocautery move laterally, providing a clearer view	Difficulty manipulating the operative arm when in applied traction
Lower incidence of cerebral desaturation events compared with the beach chair position.	Increased difficulty identifying internal and external anatomic landmarks