Arthroscopic or keyhole surgery has involved significantly over the past 25 years and failure rates are similar to open surgery. However significant experience and subspecialty training is required to master these techniques. With keyhole surgery 3-4 little cuts are traditionally made: one cut at the back is used to introduce the camera into the joint, 2 cuts in the front are then used to repair the labral tear again using suture anchors and sutures. Occasionally a fourth initial cut at the back of the shoulder is required to repair labral tears more accurately.